Presurgical Language Mapping in Patients With Intractable Epilepsy: A Review Study

Area of Science:

• Neurology
• Neuroimaging
• Epileptology

Background:

• Drug-resistant epilepsy affects 20-30% of epilepsy patients, with one-third eligible for surgery.
• Surgical resection of epileptogenic tissue is a key treatment for intractable focal epilepsy.
• Presurgical language mapping (laterality and locality) is vital for surgical planning.

Purpose of the Study:

• To review presurgical functional Magnetic Resonance Imaging (fMRI) language mapping methods.
• To discuss dedicated fMRI tasks for language localization in epilepsy patients.
• To inform the design of standardized Persian language tasks for presurgical evaluation.

Main Methods:

• Literature review of presurgical fMRI language mapping techniques.
• Analysis of various fMRI language tasks, including verbal fluency.
• Consideration of language-specific materials and technical protocols.

Main Results:

• fMRI is a non-invasive alternative to Wada testing for language mapping.
• Verbal fluency and other tasks are utilized for language laterality and locality assessment.
• Task design requires careful consideration of language materials and technical protocols.

Conclusions:

• Accurate presurgical language mapping is essential to prevent postoperative language deficits.
• This review is the initial phase of developing standardized Persian fMRI tasks.
• The project aims to improve presurgical evaluation for Iranian patients with focal epilepsy.