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Quantitative analysis on\n                      <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content>\n                      imaging and stereoelectroencephalography (\n                      <jats:styled-content style=\"fixed-case\">SEEG<\/jats:styled-content>\n                      ) signals was used to summarize their electroclinical features.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010two patients with focal epilepsy arising from the insular and\/or opercular cortex according to\n                      <jats:styled-content style=\"fixed-case\">SEEG<\/jats:styled-content>\n                      were retrospectively analyzed. Presurgical noninvasive data were analyzed in detail. Interictal\n                      <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content>\n                      data of patients were then statistically compared with those of healthy controls to identify the interictal hypometabolic network. The epileptogenicity index (\n                      <jats:styled-content style=\"fixed-case\">EI<\/jats:styled-content>\n                      ) of ictal\n                      <jats:styled-content style=\"fixed-case\">SEEG<\/jats:styled-content>\n                      signal was computed to identify areas of spread at the beginning of seizure onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Focal tonic seizures of the face and\/or neck (16\/22, 73%) were the most prevalent early objective signs. Epileptic discharges in the interictal and ictal scalp\u2010\n                      <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\n                      mostly showed an ipsilateral perisylvian distribution. Statistical analysis of interictal\n                      <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content>\n                      showed significant hypometabolism in the insular lobe, central operculum, supplementary motor area, middle cingulate cortex, bilateral caudate nuclei, and putamen. According to the\n                      <jats:styled-content style=\"fixed-case\">EI<\/jats:styled-content>\n                      analysis, insulo\u2010opercular epilepsy could be classified as insulo\u2010opercular epilepsy (50%), opercular epilepsy (41%), and insular cortex epilepsy (9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Clinical diagnosis of insulo\u2010opercular epilepsy is challenging because of its complex seizure semiology and nonlocalizing discharges on scalp\u2010\n                      <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\n                      . A common hypometabolic network involving the insulo\u2010opercular cortex, mesial frontal cortex and subcortical nuclei may be involved in the organization of the insulo\u2010opercular epilepsy network. Furthermore, quantified\n                      <jats:styled-content style=\"fixed-case\">SEEG<\/jats:styled-content>\n                      analysis suggested that pure insular epilepsy is rare, and the close connection between insular and opercular cortex necessitates\n                      <jats:styled-content style=\"fixed-case\">SEEG<\/jats:styled-content>\n                      implantation to define the epileptogenic zone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.789","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T00:27:23Z","timestamp":1560299243000},"page":"1165-1177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Electroclinical features of insulo\u2010opercular epilepsy: an\n                    <scp>SEEG<\/scp>\n                    and\n                    <scp>PET<\/scp>\n                    study"],"prefix":"10.1002","volume":"6","author":[{"given":"Xiu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Beijing Tian Tan Hospital Capital Medical University Beijing China"},{"name":"Beijing Key Laboratory of Neurostimulation Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhan","family":"Hu","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Neurostimulation Beijing China"},{"name":"Stereotactic and Functional Neurosurgery Laboratory Beijing Neurosurgical Institute Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6775-5318","authenticated-orcid":false,"given":"Aileen","family":"McGonigal","sequence":"additional","affiliation":[{"name":"INSERM UMR 1106 Institut de Neurosciences des Syst\u00e8mes Marseille France"},{"name":"Faculty of Medicine Aix\u2010Marseille University Marseille 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