Genetic Testing
Genetic defects have been reported in operculo-insular epilepsy cases, including mutations in the CHRNB2 and CHRNA4 genes in 2 patients with sleep-related hypermotor seizures (functional testing under way).24 A subtle insular focal cortical dysplasia was reported in a patient with familial focal epilepsy associated with DEPDC5 mutation.25 Finally, Nguyen and colleagues26 described an epileptogenic network involving the temporo-insular region in a family with reflex bathing epilepsy associated with a Q555X mutation of synapsin 1 on chromosome Xp11-q21.