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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

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Hemispheric lateralization and language skill coherence in temporal lobe epilepsy.

Joseph I Tracy¹, Brigid Waldron, David Glosser

¹Department of Neurology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA 19107, United States. joseph.i.tracy@jefferson.edu

Cortex; a Journal Devoted to the Study of the Nervous System and Behavior

|March 17, 2009

Summary

Early temporal lobe epilepsy (TLE) can cause language reorganization. This study found that while multiple language skills may shift hemispheres, they do not reorganize in isolation or all together, suggesting varied pressures on language representation.

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Published on: July 31, 2019

Area of Science:

Neuroscience
Epileptology
Psycholinguistics

Background:

Early-onset temporal lobe epilepsy (TLE) is linked to increased language reorganization.
The extent and pattern of language skill reorganization in TLE remain unclear.

Purpose of the Study:

To investigate language dominance concordance patterns for five distinct language skills in TLE patients.
To determine if language skills reorganize independently or as a cohesive unit.
To compare reorganization patterns between early and late seizure onset TLE groups.

Main Methods:

Utilized the Intracarotid Amobarbital Procedure (IAP) in 124 TLE patients.
Assessed lateralization patterns for five separate language skills.
Compared dominance concordance across different seizure onset times and temporal lobe foci.

Main Results:

Atypical language representation varied by skill, from 14.5% (speech) to 25.8% (reading).
Most patients (60%) with atypical representation showed it in more than one skill.
A small proportion (5.6%) exhibited atypical representation across all five skills.

Conclusions:

Language systems in TLE patients do not appear to reorganize in isolation.
Language skills do not necessarily shift together, indicating that reorganization is not monolithic.
The findings suggest that factors driving atypical language representation may affect different skills unequally.