Stuttered Swallowing: Electric Stimulation of the Right Insula Interferes with Water Swallowing. A Case Report

Authors

Peter Sörös, The University of Western Ontario
Faisal Al-Otaibi, The University of Western Ontario
Savio W. H. Wong, The University of Western Ontario
J. Kevin Shoemaker, The University of Western Ontario
Seyed M. Mirsattari, The University of Western Ontario
Vladimir Hachinski, The University of Western Ontario
Ruth E. Martin, The University of Western Ontario

Document Type

Article

Publication Date

2-5-2011

Journal

BMC Neurology

Volume

11

Issue

20

URL with Digital Object Identifier

http://dx.doi.org/10.1186/1471-2377-11-20

Abstract

BACKGROUND: Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear.

CASE PRESENTATION: Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity.

CONCLUSIONS: These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.