title: Auditory aura in frontal opercular epilepsy: sounds from afar.
abstract: Auditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory auras. Following a non-invasive evaluation, including ictal SPECT and magnetoencephalography, implicating the frontal operculum, these cases were evaluated with invasive monitoring, using stereoelectroencephalography and subdural (plus depth) electrodes, respectively. Spontaneous and electrically-induced seizures showed an ictal onset involving the frontal operculum in both cases. A typical auditory aura was triggered by stimulation of the frontal operculum in one. Resection of the frontal operculum and subjacent insula rendered one case seizure- (and aura-) free. From a hodological (network) perspective, we discuss these findings with consideration of the perisylvian and insular network(s) interconnecting the frontal and temporal lobes, and revisit the non-invasive data, specifically that of ictal SPECT.
authors.affiliation: Department of Neurology, University of Texas Health Science Center, Houston, Texas.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Thompson
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexopoulos
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: William
authors.initials: W
authors.lastname: Bingaman
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gonzalez-Martinez
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Bulacio
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Dileep
authors.initials: D
authors.lastname: Nair
authors.affiliation: Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Norman K
authors.initials: NK
authors.lastname: So
mesh_terms: D000328:Adult; D001308:Auditory Perceptual Disorders / Q000209:etiology*; D017034:Epilepsy, Frontal Lobe / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: auditory aura; frontal operculum; ictal SPECT; magnetoencephalography; perisylvian epilepsy