John Libbey Eurotext

An embarrassing aura Volume 21, issue 3, June 2019


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1 Division of Neurology, CHUM, Université de Montréal, Montreal, Canada
2 Faculty of Medicine, Université de Bordeaux II, Bordeaux, France
3 Division of Psychology, CHUM, Montreal, Canada
4 Division of Neurology, Department of Pediatrics, University of Alabama, Birmingham, USA
5 Division of Neurosurgery, CHUM, Université de Montréal, Montreal, Canada
* Correspondence: Dang Khoa Nguyen CHUM, 1000 Saint-Denis, Montréal, Canada, H2X 0C1

We report the case of a patient with epilepsy who described shame and embarrassment at the beginning of his seizures. Non-invasive and invasive presurgical investigations led to resection of the polar and ventromedial portions of the right frontal lobe. Following the surgery, the patient continued to have seizures, albeit only nocturnal and with no clear aura. Subsequent removal of the right anterior insula at the junction with the frontal operculum and the posterior orbitofrontal cortex led to seizure freedom, but the patient reported a loss of motivation and stamina and was declared unfit for work. The underlying network of negative moral emotions is briefly discussed.