J Pediatr Epilepsy 2017; 06(03): 125-132
DOI: 10.1055/s-0037-1603774
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Insular Epilepsy: Clinical, Electrophysiological Features, and Surgical Treatment

Ahmad Marashly1, Sean Lew2, Christopher Inglese1, Wade Mueller2
  • 1Division of Pediatric Neurology, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • 2Division of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Further Information

Publication History

04 February 2017

12 May 2017

Publication Date:
12 June 2017 (eFirst)


The insula, also known as the fifth lobe of the brain, is a phylogenetically older part of the cortex that forms the floor of the Sylvian fissure. It is densely connected with multiple regions in the brain, reflecting its rich functionality. Epilepsy arising from the insula has been only relatively recently described and characterized in details. Besides having unique features, the insula is believed to be the origin of seizures resembling those of suspected temporal or frontal lobe epilepsy that do not respond to traditional surgical resections. In this review article, we describe the gross and functional anatomy of the insula, clinical and electrophysiological manifestations of insular epilepsy, and surgical evaluation and treatment approaches.


All authors have contributed substantially to the conception, design, writing, and revising of this work.