John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

Auditory aura in frontal opercular epilepsy: sounds from afar Volume 17, issue 2, June 2015

Figures

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Authors
1 Department of Neurology, University of Texas Health Science Center, Houston, Texas
2 Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
* Correspondence: Norman K So Department of Neurology, University of Washington Medical Center, 1959 NE Pacific St, Box 356115, Seattle, WA 98195, USA
  • Key words: auditory aura, frontal operculum, perisylvian epilepsy, ictal SPECT, magnetoencephalography
  • DOI : 10.1684/epd.2015.0742
  • Page(s) : 150-5
  • Published in: 2015

Auditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory auras. Following a non-invasive evaluation, including ictal SPECT and magnetoencephalography, implicating the frontal operculum, these cases were evaluated with invasive monitoring, using stereoelectroencephalography and subdural (plus depth) electrodes, respectively. Spontaneous and electrically-induced seizures showed an ictal onset involving the frontal operculum in both cases. A typical auditory aura was triggered by stimulation of the frontal operculum in one. Resection of the frontal operculum and subjacent insula rendered one case seizure- (and aura-) free. From a hodological (network) perspective, we discuss these findings with consideration of the perisylvian and insular network(s) interconnecting the frontal and temporal lobes, and revisit the non-invasive data, specifically that of ictal SPECT.