As insular seizures frequently begin with preserved awareness, a clear description of the aura may yield important information that points to an insular onset. A feeling of suffocation and breathlessness, painful sensations,12 or gustatory auras7 are highly suggestive of an insular or insulo-opercular ictal origin. Interestingly, and possibly because the insula is a multimodal area involved in the processing of various sensory stimuli, insulo-opercular seizures may also manifest as eating-, audiogenic-, and somatosensory-evoked reflex seizures.7,13 Additionally, ecstatic seizures, which have been proposed to involve the anterior insular cortex, can be triggered by thinking about specific memories or a pleasant emotional context.14