Language Function After Temporal Lobectomy Without Stimulation Mapping of Cortical Function

Keith G. Davies, Robert E. Maxwell, Thomas E. Beniak, Elizabeth Destafney, Miguel E Fiol

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43 Scopus citations

Abstract

Summary We studied 95 patients who underwent standard anterior temporal lobectomy (ATL) without stimulation mapping of language areas, using neuropsychological parameters of language function preoperatively and 1 year postoperatively [Boston Naming Test and Verbal Fluency, and the Information, Comprehension, Arithmetic, Similarities, Digit Span, and Vocabulary subtests of the Wechsler Adult Intelligence Scale (WAIS)]. Verbal IQ (VIQ), Performance IQ (PIQ), Full‐scale IQ (FSIQ), and Verbal Deviation Quotient were also evaluated, as were parameters of memory function. All patients had hemisphere dominance for language assessed by an intracarotid amytal test. Fifty‐three patients had a left dominant (LHDL) ATL with a mean extent of lateral resection of 4.8 cm, and 10 had a left ATL with right or mixed hemisphere dominance (RHDL, MDL). Thirty‐two patients had a right nondominant ATL. Seizure outcome was 57 and 59% seizure‐free for LHDH and right nondominant group, respectively, 1 year after operation. Comparison of preoperative scores showed the LHDL group to have significantly lower scores than the right nondominant group for several parameters of language function and memory. The group undergoing left dominant ATL showed no significant loss of language function postoperatively and actually showed gains in many parameters. Standard ATL without stimulation mapping of language areas and with conservative lateral resection is safe for long‐term language function. In addition, evidence shows preexisting language dysfunction in patients undergoing left dominant ATL.

Original languageEnglish (US)
Pages (from-to)130-136
Number of pages7
JournalEpilepsia
Volume36
Issue number2
DOIs
StatePublished - Feb 1995

Keywords

  • Anterior temporal lobectomy
  • Epilepsy surgery
  • Hemisphere dominance
  • Language function
  • Seizures
  • Stimulation mapping
  • Wechsler Adult Intelligence Scale

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