Anterior temporal language areas in patients with early onset of temporal lobe epilepsy

Authors

  • Dr. Orrin Devinsky MD,

    Corresponding author
    1. Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases, New York, NY
    • Department of Neurology, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003
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  • Kenneth Perrine PhD.,

    1. Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases, New York, NY
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  • Rafael Llinas BA,

    1. Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases, New York, NY
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  • Daniel J. Luciano MD,

    1. Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases, New York, NY
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  • Michael Dogali MD

    1. Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases, New York, NY
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Abstract

Eighteen consecutive patients undergoing dominant temporal lobectomy underwent preoperative cortical stimulation for language localization. Patients with naming deficits on anterior (4.5 cm from the temporal pole) temporal lobe stimulation had earlier seizure onset vs those without such deficits (5.8 yr vs 12.9 yr; p < 0.04). There was a similar trend for reading errors (6.3 yr vs 12.4 yr; p < 0.052). Resections always spared at least 1 cm anterior to any langauge area. There was no significant difference in postoperative neuropsychological tests between patients with and without anterior language representation. Early onset of dominant temporal lobe seizure foci leads to a more widespread or atypical distribution of language areas. Individual variability should be considered in epilepsy surgery to reduce postoperative language deficits.

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