epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333.2018.10.4.083-092epilepsia-444Research ArticleLITERATURE SURVEYОБЗОР ЛИТЕРАТУРЫDiagnostic evaluation of drug-resistant insular epilepsyДиагностика фармакорезистентной инсулярной эпилепсииhttps://orcid.org/0000-0001-9201-2970ХачатрянР. Г.KhachatryanR. G.

Хачатрян Роза Гургеновна – аспирант кафедры неврологии и психиатрии института медицинского образования.

ул. Аккуратова, д. 2, Санкт-Петербург 197341.

Researcher ID: C-6929-2019.

Roza G. Khachatryan – PhD Student, Department of Nervous Diseases and Psychiatry.

2 Akkuratova Str., St. Petersburg 197341,

Researcher ID: C-6929-2019.

Khachatryan.roza1992@gmail.comИбатоваГ. С.IbatovaG. S.

Ибатова Гаухар Султанхановна – к. м.н., врач-невролог отделения детской нейрохирургии.

проспект Туран, д. 34/1, г. Астана 010000.

Gauhar S. Ibatova – MD, PhD, Neurologist, Department of Pediatric Neurosurgery.

34/1 Turan Avenue, Astana 010000.

goha0870@mail.ruhttps://orcid.org/0000-0002-4441-1165АлексееваТ. М.AlekseevaT. M.

Алексеева Татьяна Михайловна – д. м.н., заведующая кафедрой неврологии и психиатрии института медицинского образования.

ул. Аккуратова, д. 2, Санкт-Петербург 197341.

Researcher ID: S-8806-2017.

Tatiana M. Aleksseva – MD, PhD, Head of the Department of Nervous Diseases and Psychiatry.

2 Akkuratova Str., St. Petersburg 197341,

atmspb@mail.ruhttps://orcid.org/0000-0002-1635-6621ХачатрянВ. А.KhachatryanW. A.

Хачатрян Вильям Арамович – профессор, доктор медицинских наук, руководитель отделения нейрохирургии детского возраста НИО нейрохирургии.

ул. Аккуратова, д. 2, Санкт-Петербург 197341.

Scopus ID: 55633841500; Researcher ID: G-4002-2018.

William A. Khachatryan – MD, PhD, Professor of Neurosurgery, Head of the Department of Pediatric Neurosurgery.

2 Akkuratova Str., St. Petersburg 197341,

Scopus ID: 55633841500; Researcher ID: G-4002-2018.

wakhns@gmail.comФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации.РоссияAlmazov National Medical Research Center.Russian FederationАкционерное общество «Национальный центр Нейрохирургии».КазахстанJoint-stock company “National Center of Neurosurgery”.Kazakhstan2018280220191048393Copyright © Khachatryan R.G., Ibatova G.S., Alekseeva T.M., Khachatryan W.A., 20192019Хачатрян Р.Г., Ибатова Г.С., Алексеева Т.М., Хачатрян В.А.Khachatryan R.G., Ibatova G.S., Alekseeva T.M., Khachatryan W.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/444

About 30% of patients with temporal epilepsy are resistant to antiepileptic drugs; in such cases, surgical treatment is considered to be the best option. Existence of an extra-temporal epileptogenic focus in the insula is a possible cause of seizures after temporal lobe surgery in about 20% of patients. Because of its localization, the anatomical features of the insular lobe, as well as the entire concept of insular epilepsy have not been well documented. Yet, it has been established that the seizures developing from the insular cortex can mimic the paroxysms arising from the temporal lobe. When the insula is involved in the epileptic process, resection of the insular cortex improves the outcome of surgical treatment. Rational and well-based selection of candidates for surgical treatment is of paramount importance for patients with drug-resistant epilepsy. The article presents a review of the up-to-date literature on this matter.

Больные височной эпилепсией считаются фармакорезистентными в 30% случаев. Хирургическое лечение является наиболее оптимальным методом лечения фармакорезистентной височной эпилепсии. Наличие экстратемпорального эпилептического фокуса в островковой доле после резекции височной доли у пациентов с височной эпилепсией составляет до 20% случаев хирургических неудач. Из-за своей локализации анатомические особенности строения островка, как и концепция инсулярной эпилепсии, являются малоизученными, однако ясно, что припадки, развивающиеся из коры островковой доли, могут подражать пароксизмам, возникающим от височной доли. При вовлечении островковой доли в эпилептический процесс дополнительная резекция инсулярной коры улучшает исход хирургического лечения. Правильный выбор кандидатов имеет первостепенное значение для улучшения результатов хирургического лечения больных с медикаментозно-резистентной эпилепсией. В статье представлен подробный обзор современной литературы по данному вопросу.

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The authors declare that there are no conflicts of interest present.