{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:05:07Z","timestamp":1789664707198,"version":"4.0.1"},"reference-count":68,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A systematic review was conducted to synthesize current anatomo\u2010clinical correlations of ecstatic symptoms in focal epilepsy, aiming to provide evidence\u2010based guidance for interpreting this ictal semiology during presurgical evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed and Web of Science using terms related to ecstatic experience (e.g., ecstatic, bliss, mystical, time dilation) combined with epilepsy, seizure, or aura. This was supplemented by manual screens of review bibliographies and AI\u2010assisted queries. Of 926 selected papers, 33 were retained for localization analysis. We included studies from which lateralization and localization data could be reliably extracted and evaluated. From the extracted data, 51 patients were initially identified. The definitive analysis, however, was restricted to 9 patients who met \u201chigh\u201d or \u201cvery high\u201d confidence criteria for the correct delineation of the epileptogenic zone (EZ). A secondary analysis of the symptomatogenic zone (SZ) was conducted, drawing on data from 9 patients and identifying 14 sublobar localizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For the EZ, the highest level of evidence pointed to various subregions of the temporal lobe, particularly the anterior, basal or mesial regions, identified in 6 of the 9 high\u2010quality cases. For the SZ, the insular lobe was the most frequently identified region, particularly the dorsal anterior portion, which accounted for 9 of the 14 identified localizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Evidence from the highest\u2010quality surgical series and individual case reports consistently demonstrates that the EZ for ecstatic seizures resides in the temporal lobe or, in approximately one\u2010third of cases, extra\u2010temporal structures (insulo\u2010opercular or orbitofrontal cortex). In contrast, data from direct electrical stimulation, intracranial recordings, and ictal single\u2010photon emission computed tomography (SISCOM) strongly point to the insular cortex as the symptom\u2010generating zone. This review is limited by the relatively low number of eligible patients with sufficient electro\u2010clinical data and the high risk of bias in the existing literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70392","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:14:23Z","timestamp":1789661663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Localizing value of ecstatic phenomenon in epilepsy surgery: A systematic review"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-0314","authenticated-orcid":false,"given":"Mihai Dragos","family":"Maliia","sequence":"first","affiliation":[{"name":"\u201cVan Gogh\u201d Epilepsy Surgery Unit, Neurology Department, CIC 1414 University Hospital  Rennes France"},{"name":"Laboratory of Signal and Image Treatment University of Rennes, INSERM, LTSI\u2010U1099  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-0297","authenticated-orcid":false,"given":"Fabrice","family":"Bartolomei","sequence":"additional","affiliation":[{"name":"Epileptology and Cerebral Rhythmology Department APHM, Timone Hospital  Marseille France"},{"name":"University Aix Marseille, INSERM, INS, Institute Neuroscience System  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9120-1761","authenticated-orcid":false,"given":"Fabienne","family":"Picard","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences Geneva University Hospitals and Medical School  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","first-page":"186","article-title":"Fyodor Mikhailovitch Dostoevsky's involuntary contribution to the sympotomatology and prognosis of epilepsy. 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