{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:02:26Z","timestamp":1784872946239,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,9,30]],"date-time":"2013-09-30T00:00:00Z","timestamp":1380499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To study the utility of magnetoencephalography (<jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content>) in patients with refractory insular epilepsy. Covered by highly functional temporal, frontal, and parietal opercula, insular\u2010onset seizures can manifest a variety of ictal symptoms falsely leading to a diagnosis of temporal, frontal, or parietal lobe seizures. Lack of recognition of insular seizures may be responsible for some epilepsy surgery failures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed and analyzed <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> data in 14 patients with refractory insular seizures defined through intracranial electroencephalography (<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>) or by the presence of an epileptogenic lesion in the insula with compatible seizure semiology. <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> was performed as part of the noninvasive presurgical evaluation, using a 275\u2010channel whole head <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> system. <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> data were analyzed using a single equivalent current dipole model. <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> localization was compared to interictal positron emission tomography (<jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content>) and ictal single photon emission computed tomography (<jats:styled-content style=\"fixed-case\">SPECT<\/jats:styled-content>) results and to the resection margin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Findings<\/jats:title><jats:p>Three patterns of <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> spike sources were observed. Seven patients showed an anterior operculoinsular clusters and two patients had a posterior operculoinsular cluster. No spikes were detected in one patient, and the remaining four patients showed a diffuse perisylvian distribution. Spike sources showed uniform orientation perpendicular to the sylvian fissure. Nine patients proceeded to insular epilepsy surgery with favorable surgical outcome. Among patients with anterior operculoinsular cluster who proceeded to have surgery, <jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> provided superior information to ictal <jats:styled-content style=\"fixed-case\">SPECT<\/jats:styled-content> in four of six patients and to interictal <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content> in five of six patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MEG<\/jats:styled-content> is useful in identifying patients who are likely to benefit from epilepsy surgery targeting the insula, particularly if a tight dipole cluster is identified even if other noninvasive modalities fail to produce localizing results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12376","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T01:36:13Z","timestamp":1381541773000},"page":"1950-1959","source":"Crossref","is-referenced-by-count":76,"title":["The utility of magnetoencephalography in the presurgical evaluation of refractory insular epilepsy"],"prefix":"10.1111","volume":"54","author":[{"given":"Ismail S.","family":"Mohamed","sequence":"first","affiliation":[{"name":"Division of Neurology Department of Pediatrics IIWK Health Center Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve A.","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Division of Neurology Notre\u2010Dame Hospital (CHUM) University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Robert","sequence":"additional","affiliation":[{"name":"Department of Psychology Neuropsychology and 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