癲癇外科手術技術專家共識——第五篇：島葉癲癇外科手術技術專家共識_Journal of Epilepsy

Authors：

中國抗癲癇協會青年委員會 , 譚啟富癲癇外科發展專項基金管理委員會 , 北京神經科學學會腦功能性疾病與認知發育專業委員會 , 國家兒科及小兒外科專業醫療質量控制中心 , 《癲癇雜志》編輯部

執筆郭強（廣東三九腦科醫院），陳子怡（中山大學附屬第一醫院），彭鏡（中南大學湘雅醫院），喬梁（首都醫科大學宣武醫院），張弨（首都醫科大學附屬北京天壇醫院），隋立森（廣東省中醫院），劉強強（上海交通大學醫學院附屬瑞金醫院），李少春（廣東三九腦科醫院），劉暢（首都醫科大學附屬北京兒童醫院）;

Corresponding?author：

Keywords：

DOI：

10.7507/2096-0247.202409002

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Citation： 中國抗癲癇協會青年委員會, 譚啟富癲癇外科發展專項基金管理委員會, 北京神經科學學會腦功能性疾病與認知發育專業委員會, 國家兒科及小兒外科專業醫療質量控制中心, 《癲癇雜志》編輯部. 癲癇外科手術技術專家共識——第五篇：島葉癲癇外科手術技術專家共識. Journal of Epilepsy, 2024, 10(6): 478-486. doi: 10.7507/2096-0247.202409002 Copy

1.	中國抗癲癇協會. 臨床診療指南?癲癇病分冊. 北京: 人民衛生出版社, 2023 .
2.	張建國, 欒國明. 癲癇外科學(第3版). 北京: 人民衛生出版社, 2023.
3.	Bourdillon P, Ryvlin P, Isnard J, et al. Stereotactic electroencephalography is a safe procedure, including for insular implantations. World Neurosurgery, 2017, 99: 353-361.
4.	Alomar S, Mullin JP, Smithason S, et al. Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy. Journal of Neurosurgery, 2018, 128(4): 1147-1157.
5.	Ryvlin P, Picard F. Invasive investigation of insular cortex epilepsy. Journal of Clinical Neurophysiology, 2017, 34(4): 328-332.
6.	Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Structure & Function, 2011, 216(2): 137-149.
7.	Gasquoine PG. Contributions of the insula to cognition and emotion. Neuropsychology Review, 2014, 24(2): 77-87.
8.	Afif A, Minotti L, Kahane P, et al. Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia, 2010, 51(1): 206-213.
9.	Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(3): 984-994.
10.	Meyer S, Strittmatter M, Fischer C, et al. Lateralization in autononic dysfunction in ischemic stroke involving the insular cortex. Neuroreport, 2004, 15: 357-361.
11.	Oppenheimer SM, Gelb A, Girvin JP, et al. Cardiovascular effects of human insular cortex stimulation. Neurology, 1992, 42: 1727-1732.
12.	Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo- electroencephalography: the emergence of semiology in insula lobe seizures. Annals of Neurology, 2020, 88: 477-488.
13.	Obaid S, Chen JS, Ibrahim GM, et al. Predictors of outcomes after surgery for medically intractable insular epilepsy: a systematic review and individual participant data meta-analysis. Epilepsia Open, 2023, 8(1): 12-31.
14.	Isnard J, Guenot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(4): 1079-1090.
15.	Barba C, Rheims S, Minotti L, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(Pt 2): 444-451.
16.	BarbaC, BarbatiG, MinotiL, et al. Ictal clinical and scalp EEG findings diferentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 207, 130(Pt7): 1957- 1967.
17.	Ryvlin P, Kahane P. The hidden causes of surgery-resistant temporal lobe epilepsy: extratemporal or temporal plus? Current Opinion in Neurology, 205, 18(2): 125-127.
18.	KahaneP, BarbaC, RheimsS, et al. The concept of temporal' plus' epilepsy. RevNeurol(Paris), 2015, 171(3): 267.
19.	Lüders HO. Textbook of epilepsy surgery. United Kingdom: Informa Healthcare, 2008.
20.	Ryvlin P, Nguyen DK. Insular seizures and epilepsies: Ictal semiology and minimal invasive surgery. Current Opinion in Neurology, 2021, 34(2): 153-165.
21.	Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23: 300-308.
22.	Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. Journal of Clinical Neurophysiology, 2017, 34(4): 307-314.
23.	Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy & Behavior, 2020, 105: 106964.
24.	Aljafen BN. Insular epilepsy, an under-recognized seizure semiology. A review for general neurologist. Neurosciences (Riyadh), 2020, 25(4): 262-268.
25.	孫濤. 島葉癲癇. 2013: 人民衛生出版社.
26.	Türe U, Ya?argil MG, Al-Mefty O, et al. Arteries of the insula. Journal of Neurosurgery, 2000, 92(4): 676-687.
27.	Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. Journal of Neurosurgery, 2004, 100(5): 891-922.
28.	Talairach J, Bancaud J. Stereotaxic approach to epilepsy. Progr Neurol Surg, 1973, 5: 297-354.
29.	Isnard J, Taussig D, Bartolomei F, et al. French guidelines on stereoelectroencephalography (SEEG). Neurophysiologie Clinique, 2018, 48(1): 5-13.
30.	Surbeck W, Bouthillier A, Weil AG, et al. The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (perisylvian) epilepsy. Epilepsia, 2011, 52(3): 458-466.
31.	Cardinale F, Miserocchi A, Moscato A, et al. Talairach methodology in the multimodal imaging and robotics era //In: Scarabin J-M (ed). Stereotaxy and epilepsy surgery. John Libbey Eurotext, London, 2012: 245–272.
32.	Chilukuri AS, Awkwayena E, Abel TJ. Insulo-opercular stereoelectroencephalography exploration in children and young adults: Indications, techniques, and safety. Epilepsia Open, 2022, 7(4): 729-736.
33.	Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
34.	中國醫師協會神經外科分會功能神經外科學組, 中國抗癲癇協會, 國家神經外科手術機器人應用示范項目專家指導委員會. 立體定向腦電圖引導射頻熱凝毀損治療藥物難治性癲癇的中國專家共識. 中華神經外科雜志, 2021, 37(29): 2276-2282.
35.	Takayama Y, Kimura Y, Iijima K, et al. Volume-based radiofrequency thermocoagulation for pediatric insulo-opercular epilepsy: a feasibility study. Operative Neurosurgery, 2022, 23(3): 241-249.
36.	Rey-Dios R, Cohen-Gadol AA. Technical nuances for surgery of insular gliomas: lessons learned. Neurosurgical Focus, 2013, 34(2): E6.
37.	Yarsargil M, Von Ammon K, Cavazos E, et al. Tumours of the limbic and paralimbic systems. Acta Neurochirurgica, 1992, 118(1): 40-52.
38.	Duffau H, Capelle L, Lopes M, et al. Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochirurgica, 2002, 144(2): 563-573.
39.	Chevrier M-C, Bard C, Guilbert F, et al. Structural abnormalities in patients with insular/peri-insular epilepsy: spectrum, frequency, and pharmacoresistance. American Journal of Neuroradiology, 2013, 34(10): 2152-2156.
40.	von Lehe M, Wellmer J, Urbach H, et al. Insular lesionectomy for refractory epilepsy: management and outcome. Brain, 2009, 132(4): 1048-1056.
41.	Yasargil MG, Krisht AF, Ture U, et al. Microsurgery of insular gliomas, part II: opening of the sylvian fissure. Contemporary Neurosurgery, 2002, 24(8): 1-6.
42.	Laoprasert P, Ojemann JG, Handler MH. Insular epilepsy surgery. Epilepsia, 2017, 58(Suppl 1): 35-45.
43.	Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: Is it effective? Journal of Neurosurgery, 2019, 20(1): 1-10.
44.	Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 2: Is it safe? Journal of Neurosurgery, 2019, 20(1): 1-11.
45.	Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Currents, 2019, 19(1): 11-21.
46.	Wu C, Sharan AD. Neurostimulation for the treatment of epilepsy: a review of current surgical interventions. Neuromodulation, 2013, 16(1): 10-24.
47.	Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neuro- stimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia, 2017, 58(6): 1005-1014.
48.	孫濤. 島葉癲癇. 中華神經外科雜志, 2014, 30(10): 976-978.
49.	Scarabin JM, Seigneuret E, Pasqualini E, et al. The tailored cortectomies//Scarabin JM, Mercier P, Guénot M, et al. Stereotaxy and Epilepsy Surgery. United Kingdom: John Libbey Eurotext Limited, 2012: 307-311.
50.	Malak R, Bouthillier A, Carmant L, et al. Microsurgery of epileptic foci in the insular region. Journal of Neurosurgery, 2009, 110(6): 1153-1163.
51.	郭強, 王艮波, 張偉, 等. 立體腦電圖引導外科治療顳島型顳葉癲癇附加癥. 中華神經外科雜志, 2018, 34(12): 1217-1221.
52.	Duffau H, Taillandier L, Gatignol P, et al. The insular lobe and brain plasticity: lessons from tumor surgery. Clinical Neurology and Neurosurgery, 2006, 108(6): 543-548.
53.	Meyer FB, Bates LM, Goerss SJ, et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clinic Proceedings, 2001, 76(7): 677-687.
54.	中國腦膠質瘤協作組, 中國醫師協會腦膠質瘤專業委員會. 喚醒狀態下切除腦功能區膠質瘤手術技術指南(2018版). 中國微侵襲神經外科雜志, 2018, 23(8): 383-388.
55.	Saito R, Kumabe T, Inoue T, et al. Magnetic resonance imaging for preoperative identification of the lenticulostriate arteries in insular glioma surgery. Technical note. Journal of Neurosurgery, 2009, 111(2): 278-281.
56.	Dasenbrock HH, See AP, Smalley RJ, et al. Frameless stereotactic navigation during insular glioma resection using fusion of three-dimensional rotational angiography and magnetic resonance imaging. World Neurosurgery, 2019, 126(2): 322-330.
57.	張戈. 島葉膠質瘤的顯微外科手術治療, 中華顯微外科雜志, 2005, 28(3): 278-279.
58.	韓正中, 谷佳, 韓宇涵, 等. 顯微外科治療島葉膠質瘤的療效分析. 局解手術學雜志, 2019, 28(12): 949-953.
59.	Loan JJM, Wiggins AN, Brennan PM. Medically induced hypertension, hypervolaemia and haemodilution for the treatment and prophylaxis of vasospasm following aneurysmal subarachnoid haemorrhage: systematic review. British Journal of Neurosurgery, 2018, 32(2): 157-164.
60.	Duffau H, Bauchet L, Lehéricy S, et al. Functional compensation of the left dominant insula for language. Neuroreport, 2001, 12(10): 2159-2163.

1. 中國抗癲癇協會. 臨床診療指南?癲癇病分冊. 北京: 人民衛生出版社, 2023 .
2. 張建國, 欒國明. 癲癇外科學(第3版). 北京: 人民衛生出版社, 2023.
3. Bourdillon P, Ryvlin P, Isnard J, et al. Stereotactic electroencephalography is a safe procedure, including for insular implantations. World Neurosurgery, 2017, 99: 353-361.
4. Alomar S, Mullin JP, Smithason S, et al. Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy. Journal of Neurosurgery, 2018, 128(4): 1147-1157.
5. Ryvlin P, Picard F. Invasive investigation of insular cortex epilepsy. Journal of Clinical Neurophysiology, 2017, 34(4): 328-332.
6. Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Structure & Function, 2011, 216(2): 137-149.
7. Gasquoine PG. Contributions of the insula to cognition and emotion. Neuropsychology Review, 2014, 24(2): 77-87.
8. Afif A, Minotti L, Kahane P, et al. Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia, 2010, 51(1): 206-213.
9. Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(3): 984-994.
10. Meyer S, Strittmatter M, Fischer C, et al. Lateralization in autononic dysfunction in ischemic stroke involving the insular cortex. Neuroreport, 2004, 15: 357-361.
11. Oppenheimer SM, Gelb A, Girvin JP, et al. Cardiovascular effects of human insular cortex stimulation. Neurology, 1992, 42: 1727-1732.
12. Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo- electroencephalography: the emergence of semiology in insula lobe seizures. Annals of Neurology, 2020, 88: 477-488.
13. Obaid S, Chen JS, Ibrahim GM, et al. Predictors of outcomes after surgery for medically intractable insular epilepsy: a systematic review and individual participant data meta-analysis. Epilepsia Open, 2023, 8(1): 12-31.
14. Isnard J, Guenot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(4): 1079-1090.
15. Barba C, Rheims S, Minotti L, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(Pt 2): 444-451.
16. BarbaC, BarbatiG, MinotiL, et al. Ictal clinical and scalp EEG findings diferentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 207, 130(Pt7): 1957- 1967.
17. Ryvlin P, Kahane P. The hidden causes of surgery-resistant temporal lobe epilepsy: extratemporal or temporal plus? Current Opinion in Neurology, 205, 18(2): 125-127.
18. KahaneP, BarbaC, RheimsS, et al. The concept of temporal' plus' epilepsy. RevNeurol(Paris), 2015, 171(3): 267.
19. Lüders HO. Textbook of epilepsy surgery. United Kingdom: Informa Healthcare, 2008.
20. Ryvlin P, Nguyen DK. Insular seizures and epilepsies: Ictal semiology and minimal invasive surgery. Current Opinion in Neurology, 2021, 34(2): 153-165.
21. Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23: 300-308.
22. Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. Journal of Clinical Neurophysiology, 2017, 34(4): 307-314.
23. Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy & Behavior, 2020, 105: 106964.
24. Aljafen BN. Insular epilepsy, an under-recognized seizure semiology. A review for general neurologist. Neurosciences (Riyadh), 2020, 25(4): 262-268.
25. 孫濤. 島葉癲癇. 2013: 人民衛生出版社.
26. Türe U, Ya?argil MG, Al-Mefty O, et al. Arteries of the insula. Journal of Neurosurgery, 2000, 92(4): 676-687.
27. Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. Journal of Neurosurgery, 2004, 100(5): 891-922.
28. Talairach J, Bancaud J. Stereotaxic approach to epilepsy. Progr Neurol Surg, 1973, 5: 297-354.
29. Isnard J, Taussig D, Bartolomei F, et al. French guidelines on stereoelectroencephalography (SEEG). Neurophysiologie Clinique, 2018, 48(1): 5-13.
30. Surbeck W, Bouthillier A, Weil AG, et al. The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (perisylvian) epilepsy. Epilepsia, 2011, 52(3): 458-466.
31. Cardinale F, Miserocchi A, Moscato A, et al. Talairach methodology in the multimodal imaging and robotics era //In: Scarabin J-M (ed). Stereotaxy and epilepsy surgery. John Libbey Eurotext, London, 2012: 245–272.
32. Chilukuri AS, Awkwayena E, Abel TJ. Insulo-opercular stereoelectroencephalography exploration in children and young adults: Indications, techniques, and safety. Epilepsia Open, 2022, 7(4): 729-736.
33. Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
34. 中國醫師協會神經外科分會功能神經外科學組, 中國抗癲癇協會, 國家神經外科手術機器人應用示范項目專家指導委員會. 立體定向腦電圖引導射頻熱凝毀損治療藥物難治性癲癇的中國專家共識. 中華神經外科雜志, 2021, 37(29): 2276-2282.
35. Takayama Y, Kimura Y, Iijima K, et al. Volume-based radiofrequency thermocoagulation for pediatric insulo-opercular epilepsy: a feasibility study. Operative Neurosurgery, 2022, 23(3): 241-249.
36. Rey-Dios R, Cohen-Gadol AA. Technical nuances for surgery of insular gliomas: lessons learned. Neurosurgical Focus, 2013, 34(2): E6.
37. Yarsargil M, Von Ammon K, Cavazos E, et al. Tumours of the limbic and paralimbic systems. Acta Neurochirurgica, 1992, 118(1): 40-52.
38. Duffau H, Capelle L, Lopes M, et al. Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochirurgica, 2002, 144(2): 563-573.
39. Chevrier M-C, Bard C, Guilbert F, et al. Structural abnormalities in patients with insular/peri-insular epilepsy: spectrum, frequency, and pharmacoresistance. American Journal of Neuroradiology, 2013, 34(10): 2152-2156.
40. von Lehe M, Wellmer J, Urbach H, et al. Insular lesionectomy for refractory epilepsy: management and outcome. Brain, 2009, 132(4): 1048-1056.
41. Yasargil MG, Krisht AF, Ture U, et al. Microsurgery of insular gliomas, part II: opening of the sylvian fissure. Contemporary Neurosurgery, 2002, 24(8): 1-6.
42. Laoprasert P, Ojemann JG, Handler MH. Insular epilepsy surgery. Epilepsia, 2017, 58(Suppl 1): 35-45.
43. Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: Is it effective? Journal of Neurosurgery, 2019, 20(1): 1-10.
44. Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 2: Is it safe? Journal of Neurosurgery, 2019, 20(1): 1-11.
45. Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Currents, 2019, 19(1): 11-21.
46. Wu C, Sharan AD. Neurostimulation for the treatment of epilepsy: a review of current surgical interventions. Neuromodulation, 2013, 16(1): 10-24.
47. Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neuro- stimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia, 2017, 58(6): 1005-1014.
48. 孫濤. 島葉癲癇. 中華神經外科雜志, 2014, 30(10): 976-978.
49. Scarabin JM, Seigneuret E, Pasqualini E, et al. The tailored cortectomies//Scarabin JM, Mercier P, Guénot M, et al. Stereotaxy and Epilepsy Surgery. United Kingdom: John Libbey Eurotext Limited, 2012: 307-311.
50. Malak R, Bouthillier A, Carmant L, et al. Microsurgery of epileptic foci in the insular region. Journal of Neurosurgery, 2009, 110(6): 1153-1163.
51. 郭強, 王艮波, 張偉, 等. 立體腦電圖引導外科治療顳島型顳葉癲癇附加癥. 中華神經外科雜志, 2018, 34(12): 1217-1221.
52. Duffau H, Taillandier L, Gatignol P, et al. The insular lobe and brain plasticity: lessons from tumor surgery. Clinical Neurology and Neurosurgery, 2006, 108(6): 543-548.
53. Meyer FB, Bates LM, Goerss SJ, et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clinic Proceedings, 2001, 76(7): 677-687.
54. 中國腦膠質瘤協作組, 中國醫師協會腦膠質瘤專業委員會. 喚醒狀態下切除腦功能區膠質瘤手術技術指南(2018版). 中國微侵襲神經外科雜志, 2018, 23(8): 383-388.
55. Saito R, Kumabe T, Inoue T, et al. Magnetic resonance imaging for preoperative identification of the lenticulostriate arteries in insular glioma surgery. Technical note. Journal of Neurosurgery, 2009, 111(2): 278-281.
56. Dasenbrock HH, See AP, Smalley RJ, et al. Frameless stereotactic navigation during insular glioma resection using fusion of three-dimensional rotational angiography and magnetic resonance imaging. World Neurosurgery, 2019, 126(2): 322-330.
57. 張戈. 島葉膠質瘤的顯微外科手術治療, 中華顯微外科雜志, 2005, 28(3): 278-279.
58. 韓正中, 谷佳, 韓宇涵, 等. 顯微外科治療島葉膠質瘤的療效分析. 局解手術學雜志, 2019, 28(12): 949-953.
59. Loan JJM, Wiggins AN, Brennan PM. Medically induced hypertension, hypervolaemia and haemodilution for the treatment and prophylaxis of vasospasm following aneurysmal subarachnoid haemorrhage: systematic review. British Journal of Neurosurgery, 2018, 32(2): 157-164.
60. Duffau H, Bauchet L, Lehéricy S, et al. Functional compensation of the left dominant insula for language. Neuroreport, 2001, 12(10): 2159-2163.

Journal of Epilepsy

癲癇外科手術技術專家共識——第五篇：島葉癲癇外科手術技術專家共識

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