Direct electrical stimulations of the temporal pole in human.
We report the results of 105 intracortical electrical stimulations of the temporo-polar cortex performed in 30 patients during stereo-electroencephalography (SEEG) investigation of drug-resistant temporal lobe epilepsy. Clinical responses were elicited in 50% of the patients during 26 of the 105 stimulations. Responses are coherent with data found in the literature with mostly psychic, viscero-sensitive, autonomic and viscero-motor phenomena being elicited. Nearly all responses were evoked by stimulation of the antero-medial part of the temporo-polar cortex whereas only once was a clinical response elicited during stimulation of the lateral part of the temporo-polar cortex. Induced auras were more frequently reported when there was an afterdischarge associated to the clinical response (60 and 75% of the stimulation followed by a localized or a diffusing after-discharge, respectively) then when there wasn't any after-discharge following stimulation. The clinical responses evoked during stimulation of the temporo-polar cortex only have a limited topographic specificity since they closely resemble symptoms elicited by stimulation of other limbic or paralimbic areas. Nonetheless these results do suggest that the antero-medial part of the temporo-polar cortex is included in the symptomatogenic zone in so-called "temporo-limbic" epilepsies.
Ostrowsky
Karine
K
Functional Neurology and Epileptology Unit, University Neurological Hospital, Lyon, France. ostrowsky@caramail.com
Desestret
Virginie
V
Ryvlin
Philippe
P
Coste
Sébastien
S
Mauguière
François
F
D004558:Electric Stimulation / Q000295:instrumentation; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000378:metabolism; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D013238:Stereotaxic Techniques; D013702:Temporal Lobe / Q000502:physiology*; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18