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Postictal Language Dysfunction in Patients with Right or Bilateral Hemispheric Language Localization
Author(s) -
Privitera Michael,
Kohler Christian,
Cahill William,
Yeh HwaShain
Publication year - 1996
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1996.tb00530.x
Subject(s) - wada test , amobarbital , psychology , epilepsy , audiology , temporal lobe , lateralization of brain function , dominance (genetics) , anterior temporal lobectomy , electroencephalography , cognitive psychology , medicine , neuroscience , biochemistry , chemistry , gene
Summary:Purpose : As shown previously, when temporal lobe complex partial seizures (TLCPS) originate from the language dominant hemisphere, patients cannot read a test phrase correctly within 60 s of the end of the ictal discharge. We wished to assess whether postictal language testing results discordant with this pattern identified patients with non‐left (right hemisphere or mixed) language dominance. Methods : Since 1988, all patients undergoing video/EEG monitoring at our institution have been given a test phrase to read aloud as soon as a seizure is detected. Inclusion criteria for this study were (a) postictal language testing within 60 s of seizure end for at least one TLCPS, (b) >90% seizure reduction after anterior temporal lobectomy with 2‐year minimum follow‐ follow‐ up, and (c) language localization by either intracarotid amobarbital test (IAT) or direct electrical stimulation of left hemisphere cortex. Results : Two hundred twenty‐four seizures in 64 patients were analyzed. Discordant postictal language patterns were noted in 10 of 11 patients with IAT documented non‐left language dominance and in 15 of 53 with left dominance (p = 0.006; sensitivity 90.9%, specificity 71.7%). Conclusions : Postictal language testing accurately identifies patients with non‐left language dominance and may be useful in selecting appropriate patients for IAT.