The concept of insular epilepsy has long remained speculative. Due to anatomical constraints, the insula is deeply buried under the opercula and is covered by the sylvian arteriovenous network. This structure remained inaccessible to electrophysiological investigations using intracranial electrodes and, unlike the temporal, frontal, parietal and occipital lobes, little is known about the role of the insula lobe in partial epilepsies.The notion of insular epilepsy, which remained somewhat anonymous after Penfield's work, has received renewed interest in the last ten years after several prominent clinical cases were reported in the literature, and the development of functional neuroimaging has allowed a better understanding of the physiological role of the human insula. However, no systematic study of insular epilepsy has been conducted and the clinical semiology of insular seizures remains unknown.