The non-invasive localisation of insular lobe epilepsy (ILE) continues to pose a challenge. The suggestion of insular cortex involvement is often based upon recognition of the described clinical semiology[1–4]. Non-invasive neurophysiological investigation is often non-localising and at times discordant to the hypothesis of insular lobe involvement [5]. With these difficulties, many cases progress to intracranial EEG evaluation to achieve a surgical solution.

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