Ictal bradycardia and asystole in an adult with a focal left insular lesion

Tayah, Tania; Savard, Martin; Desbiens, Richard; Nguyen, Dang Khoa

doi:10.1016/j.clineuro.2013.04.011

Cited by 41 publications

(23 citation statements)

References 9 publications

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“…Insular damage in patients with cerebral infarction is associated with increased sympathetic activity, cardiac arrhythmias [9], conduction blocks and mortality, including due to sudden death [10, 11]. Non-fatal ictal bradycardia and asystole have been reported in insular epilepsy [12, 13]. Insular seizures have been implicated in just one previous case of SUDEP.…”

Section: Discussionmentioning

confidence: 99%

Left-insular damage, autonomic instability, and sudden unexpected death in epilepsy

Lacuey

Zonjy

Theerannaew

et al. 2016

Epilepsy & Behavior

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We analyzed the only two sudden unexpected death in epilepsy (SUDEP) cases from 320 prospectively recruited patients in the three-year Prevention and Risk Identification of SUDEP Mortality (PRISM) Project. Both patients had surgically refractory epilepsy, evidence of left insular damage following previous temporal/temporo-insular resections, and progressive changes in Heart Rate Variability (HRV) in monitored evaluations prior to death. Insular damage is known to cause autonomic dysfunction and increased mortality in acute stroke. This report suggests a possible role for the insula in the pathogenesis of SUDEP. The presence of intrinsic insular lesions or acquired insular damage in refractory epilepsy patients may be an additional risk factor for SUDEP.

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Section: Discussionmentioning

confidence: 99%

Left-insular damage, autonomic instability, and sudden unexpected death in epilepsy

Lacuey

Zonjy

Theerannaew

et al. 2016

Epilepsy & Behavior

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“…In recent years, tract-tracing studies have supported the view of a central viscero-somatosensory role for the insula, which is now known to receive visceral afferent projections conveying interoceptive information from all over the body 27 . Later studies of direct electro-cortical stimulation confirmed Penfield’s findings 25, 26, 28 .…”

Section: Insula Functionmentioning

confidence: 94%

“…Beyond visceral information processing, it has been proposed that the insula plays a broader role in interoception, i.e., the sense of the physiological condition of the body 27 . Indeed, functional neuroimaging studies have reported heightened insular activation when participants are made aware of their thirst, heartbeat, and distention of the esophagus, stomach, bladder, or rectum 27, 31 .…”

Section: Insula Functionmentioning

confidence: 99%

“…Indeed, functional neuroimaging studies have reported heightened insular activation when participants are made aware of their thirst, heartbeat, and distention of the esophagus, stomach, bladder, or rectum 27, 31 . Congruently, insular lesions have been associated with delayed moment-to-moment awareness of cardiovascular sensations and with anoognosia for hemiplegia/hemiparesis 32, 33 .…”

Section: Insula Functionmentioning

confidence: 99%

“…As a cortical center of visceral information processing and interoception, the anterior insula is thought to play a crucial role in emotional experience and subjective feelings 27 . Indeed, inter-individual differences in interoceptive sensitivity correlate with reports of negative emotional experience, both of which are predicted by right anterior insular activation while paying attention to internal bodily processes 60 .…”

Section: Insula Functionmentioning

confidence: 99%

See 2 more Smart Citations

Structure and Function of the Human Insula

Uddin

Nomi

Hébert-Seropian

et al. 2017

Journal of Clinical Neurophysiology

926

604

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The insular cortex, or “Island of Reil”, is hidden deep within the lateral sulcus of the brain. Subdivisions within the insula have been identified on the basis of cytoarchitectonics, sulcal landmarks, and connectivity. Depending on the parcellation technique employed, the insula can be divided into anywhere between 2 and 13 distinct subdivisions. The insula subserves a wide variety of functions in humans ranging from sensory and affective processing to high-level cognition. Here we provide a concise summary of known structural and functional features of the human insular cortex with a focus on lesion case studies and recent neuroimaging evidence for considerable functional heterogeneity of this brain region.

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Vestibular responses to direct stimulation of the human insular cortex

Mazzola

Lopez

Faillenot

et al. 2014

Annals of Neurology

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These results demonstrate vestibular sensory processing in the insula that is centered on its posterior part. The present data add to the understanding of the multiple sensory functions of the insular cortex and of the cortical processing of vestibular signals. The data also indicate that lesion or dysfunction in the posterior insula should be considered during the evaluation of vestibular epileptic seizures.

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Ictal bradycardia and asystole in an adult with a focal left insular lesion

Cited by 41 publications

References 9 publications

Left-insular damage, autonomic instability, and sudden unexpected death in epilepsy

Left-insular damage, autonomic instability, and sudden unexpected death in epilepsy

Structure and Function of the Human Insula

Vestibular responses to direct stimulation of the human insular cortex

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