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Table 2 Evolution of semiology and seizure location based on SEEG data

From: Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study

Patient No. (n = 8)

No. of seizures recorded

No. of seizures analyzed (A20,S40)

Seizure duration

BATS duration

Evolution of semiology

Seizure onset and propogation

Stimulation site

Epileptogenic zone

SIA

SIS

1

A0,S6

S5

77–100 s

9–22 s

Focal tonic (Rt arm occurring in 2 out of 5 seizures [2/5]) → BATS (four limbs 5/5,face 4/5) → EM (cont. Deviation3/5,ips.deviation 1/5, convergence 1/5) → Focal TCS (Rt arm 1/5, face 5/5) → GTCS (5/5)

Cop→MCC + sls + Fop

Undone

Undone

Lt-INS + OP

2

A1,S12

A1,S5

5–52 s

5–19 s

Aura (Rt arm numb 3/6) → Autonomic (nausea 1/6) → BATS (4limbs 6/6,face 2/6, ips.eyelid 2/6) → Focal TCS (eyelids 4/6)

plg + sls → asg

Undone

Undone

Lt-INS

3

A3,S12

A3,S5

27–42 s

20–32 s

Autonomic (tachycardia 8/8,hypersalivation 2/8) → Focal dystonia (Rt hand 2/8) → BATS (four limbs 8/8, cont.face+eyelid 5/8) → Hypermotor (shake head 4/8) → Focal TCS (throat 2/8,eyelids 3/8)

msg → asg → alg + plg + als

Undone

Undone

Lt-INS

4

A16,S46

A5,S5

13–66 s

7–56 s

Aura (indescribable) → BATS (four limbs 10/10,face 3/10) → Focal TCS (Rt arm 8/10)

plg → ils → psg

plg, ils, Pop

Not induced

Lt-INS

5

A0,S41

S5

20–23 s

14–20 s

BATS (four limbs 5/5) → Hypermotor (pedaling 3/5) → Focal TCS (Lt arm 5/5, eyelid 5/5)

alg → Pop→plg

Not induced

Pop, HG

Rt-INS + OP

6

A2,S46

A2,S5

22–69 s

7–29 s

BATS (four limbs 7/7) → EM (forced upward stare 3/7, cont.deviation 1/7) → Focal TCS (Lt arm 4/7, eyelid 3/7)

plg → sls → apex+psg + Pop +TP

Undone

Undone

Rt-INS + OP

7

A > 50,S > 50

A5,S5

12–35 s

9–20 s

BATS (four limbs 10/10) → Focal tonic (Rt face+eyelid 8/10) → EM (ips.deviation 6/10) → Focal TCS (limbs 6/10, eyelids 10/10)

psg → Cop→plg + ils + msg + Pop+SMA

Undone

Undone

Lt-INS + OP

8

A10,S7

A5,S5

8–62 s

6–31 s

Focal tonic (pouting 2/10) → BATS (four limbs 10/10, face 6/10) → EM (ips.deviation 2/10, cont. deviation 1/10)

IFGop

Not induced

ds

Lt-OP

  1. SIA stimulating induced aura, SIS stimulating induced seizure, A awake, S sleep, Lt left, Rt right, Bil bilateral, cont contralateral, ips ipsilateral, BATS bilateral asymmetic tonic seizure, TCS tonic-clonic seizure, GTCS generalized tonic clonic seizure, EM eye movement, SMA supplementary sensorimotor area, asg anterior short gyrus of insula, msg middle short gyrus of insula, psg posterior short gyrus of insula, alg anterior long gyrus of insula, plg posterior long gyrus of insula, als anterior limiting sulcus, sls superior limiting sulcus, ils inferior limiting sulcus, OP operculum, Fop frontal operculum (inferior frontal gyrus trianglar part and opercular part), IFGop inferior frontal gyrus opercular part, ds diagonal sulcus, Cop central operculum, Pop parietal operculum, Top temporal operculum, MCC middle part of cingular cortex, TP temporal pole, HG Heschl’s gyrus