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Related Experiment Videos

Postictal language dysfunction in patients with right or bilateral hemispheric language localization

M Privitera1, C Kohler, W Cahill

  • 1Department of Neurology, University of Cincinnati Medical Center 45267-0525, USA.

Epilepsia
|October 1, 1996
PubMed
Summary

Postictal language testing accurately identifies patients with non-left hemisphere language dominance. This method may help select patients for the intracarotid amobarbital test (IAT).

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Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Temporal lobe complex partial seizures (TLCPS) originating from the language dominant hemisphere impair reading ability post-seizure.
  • Previous research established a pattern of impaired reading within 60 seconds of seizure end for left-hemisphere dominant seizures.

Purpose of the Study:

  • To determine if discordant postictal language testing patterns can identify patients with non-left hemisphere language dominance.
  • To assess the utility of postictal language testing in localizing language dominance.

Main Methods:

  • Video/EEG monitoring with a standardized reading test administered within 60 seconds of seizure cessation.
  • Inclusion criteria included successful postictal testing, >90% seizure reduction after anterior temporal lobectomy, and confirmed language localization via intracarotid amobarbital test (IAT) or cortical stimulation.

Related Experiment Videos

  • Analysis of 224 seizures from 64 patients.
  • Main Results:

    • Discordant postictal language patterns were observed in 90.9% of patients with non-left hemisphere language dominance (10/11).
    • These patterns were also noted in 28.3% of patients with left hemisphere dominance (15/53), with a p-value of 0.006.
    • The sensitivity and specificity for identifying non-left language dominance were 90.9% and 71.7%, respectively.

    Conclusions:

    • Postictal language testing is a valuable tool for accurately identifying patients with non-left hemisphere language dominance.
    • This testing may serve as a useful adjunct in selecting patients for further evaluation with the intracarotid amobarbital test (IAT).