Gustatory epileptic aura: mesiotemporal versus insular localization? Case report studied with stereo-EEG
DOI:
https://doi.org/10.20453/rnp.v88i4.6329Keywords:
gustatory aura, epilepsy, localizing value, SEEGAbstract
Gustatory epileptic auras are uncommon and have been described as locating ictal onset in the mesiotemporal region, insula or parietal operculum. We report the case of a patient with drug-resistant focal epileptic seizures, with limbic semiology and gustatory auras. After performing phase 1 of presurgical studies for epilepsy surgery, the patient was evaluated with stereo-EEG. The electroclinical findings and their analysis of spatiotemporal dynamics led to the conclusion that it was an epileptogenic network, with ictal onset in the mesiotemporal and left anterior insular (temporal plus) regions. The gustatory aura, when part of the early ictal semiology, suggests involvement of the insulo-opercular region in the ictal onset zone. The ictal origin of the patient's gustatory auras is discussed and a review of the related literature is performed.
Downloads
References
Liu Y, Guo XM, Wu X, Li P, Wang WW. Clinical analysis of partial epilepsy with auras. Chin Med J [Internet]. 2017; 130(3): 318-322. Disponible en: https://doi.org/10.4103/0366-6999.198918
Blume WT, Lüders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia [Internet]. 2001; 42(9): 1212-1218. Disponible en: https://doi.org/10.1046/j.1528-1157.2001.22001.x
Palacios E, Clavijo-Prado C. Semiología de la crisis epiléptica: un reto clínico. Repert Med Cir [Internet]. 2016; 25(4): 203-209. Disponible en: https://doi.org/10.1016/j.reper.2016.10.007
Fernández-Torre JL. Auras epilépticas: clasificación, fisiopatología, utilidad práctica, diagnóstico diferencial y controversias. Rev Neurol [Internet]. 2002; 34(10): 977-983. Disponible en: https://doi.org/10.33588/rn.3410.2001259
Nariño-González D, Gómez-Arias B, Lizcano-Meneses A. Aspectos electroclínicos de la epilepsia temporal mesial. Acta Neurol Colomb [Internet]. 2023; 39(3): e732. Disponible en: https://doi.org/10.22379/anc.v39i3.732
Maillard L, Vignal JP, Gavaret M, Guye M, Biraben A, McGonigal A, et al. Semiologic and electrophysiologic correlations in temporal lobe seizure subtypes. Epilepsia [Internet]. 2004; 45(12): 1590-1599. Disponible en: https://doi.org/10.1111/j.0013-9580.2004.09704.x
Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. J Clin Neurophysiol [Internet]. 2017; 34(4): 307-314. Disponible en: https://doi.org/10.1097/WNP.0000000000000382
Mazzola L, Royet JP, Catenoix H, Montavont A, Isnard J, Mauguire F. Gustatory and olfactory responses to stimulation of the human insula. Ann Neurol [Internet]. 2017; 82(3): 360-370. Disponible en: https://doi.org/10.1002/ana.25010
Veldhuizen MG, Albrecht J, Zelano C, Boesveldt S, Breslin P, Lundstreöm J. Identification of human gustatory cortex by activation likelihood estimation. Hum Brain Mapp [Internet]. 2011; 32(12): 2256-2266. Disponible en: https://doi.org/10.1002/hbm.21188
Rossetti AO, Mortati KA, Black PM, Bromfield EB. Simple partial seizures with hemisensory phenomena and dysgeusia: an insular pattern. Epilepsia [Internet]. 2005; 46(4): 590-591. Disponible en: https://doi.org/10.1111/j.0013-9580.2005.61904.x
Kahane P, Barba C, Rheims S, Job-Chapron AS, Minotti L, Ryvlin P. The concept of temporal ‘plus’ epilepsy. Rev Neurol (Paris) [Internet]. 2015; 171(3): 267-272. Disponible en: https://doi.org/10.1016/j.neurol.2015.01.562
Russo A, Arbune AA, Bansal L, Mindruta I, Gobbi G, Duchowny M. The localizing value of epileptic auras: pitfalls in semiology and involved networks. Epileptic Disord [Internet]. 2019; 21(6): 519-528. Disponible en: https://doi.org/10.1684/epd.2019.1106
Russo A, Jakayar P, Miller I, Bathia S, Duchowny M. A16-year-old girl with focal seizures and impaired awareness: divergent non-invasive data related to a diffuse epileptogenic network. Epileptic Disord [Internet]. 2016; 18(2): 187-194. Disponible en: https://doi.org/10.1684/epd.2016.0820
Toro-Pérez J, Suller-Martí A, Herrera M, Bottan J, Burneo JG. Temporal plus epilepsy: a review. Rev Neurol [Internet]. 2020; 71(6): 225-233. Disponible en: https://doi.org/10.33588/rn.7106.2020339
Oddo S, Giagante B, Seoane E, Seoane P, Princich JP, Campora N, et al. Enhancing epilepsy care in Argentina: use of SEEG in a developing setting. Neurophysiol Clin [Internet]. 2025; 55(2): 103045. Disponible en: https://doi.org/10.1016/j.neucli.2025.103045
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Los autores

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.















RNP is distributed under a