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Language Lateralization in Patients with Temporal Lobe Epilepsy : A Comparison between Volumetric Analysis and the Wada Test

Oh, Young-Min    (Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School   ); Koh, Eun-Jeong    (Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School  );
  • 초록

    Objective : Determining language lateralization is important for the presurgical evaluation of patients with medically intractable epilepsy. The Wada test has been the gold standard for lateralization of language dominance before epilepsy surgery. However, it is an invasive test with risk, and have some limitations. Methods : We compared the volumetric analysis with Wada test, and studied the clinical potential of volumetric analysis to assess language laterality in large surgical candidates with temporal lobe epilepsy (TLE). To examine the efficacy of volumetric analysis to determine language lateralization during presurgical evaluation, we compared the volumetric analysis of the bilateral planum temporale with the results of Wada test in 59 patients with chronic intractable TLE (rTLE, n=32; lTLE, n=27) who underwent epilepsy surgery. We measured the gray matter volumes of planum temporale (PT) of each patients using the VoxelPlus2 program (Mevisys, Daejeon, Korea). Results : Overall congruence of the volumetric analysis with the Wada test was 97.75% in rTLE patients and 81.5% in lTLE patients. There were more significant leftward asymmetry of the PT in rTLE patients than lTLE patients. In lTLE patients, relatively high proportion (37%) of the patients showed bilateral or right hemispheric language dominance. Conclusion : These results provide evidence that the volumetric analysis of the PT could be used as an alternatives in language lateralization. Also, the results of the Wada test suggested that there was considerable plasticity of language representation in the brains of patients with intractable TLE and it was associated with an earlier age of brain injury.


  • 주제어

    Cerebral dominance .   Temporal lobe epilepsy .   Wada .   Volume.  

 저자의 다른 논문

  • Oh, Young-Min (9)

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    2. 2006 "Surgical Strategies in Patients with the Supplementary Sensorimotor Area Seizure" Journal of Korean Neurosurgical Society = 대한신경외과학회지 40 (5): 323~329    
    3. 2007 "Seizure Control in Patients with Extratemporal Lobe Epilepsy" Journal of Korean Neurosurgical Society = 대한신경외과학회지 41 (5): 283~290    
    4. 2008 "Effect of Vagus Nerve Stimulation in Post-Traumatic Epilepsy and Failed Epilepsy Surgery : Preliminary Report" Journal of Korean Neurosurgical Society = 대한신경외과학회지 44 (4): 196~198    
    5. 2008 "Congenital Absence of a Cervical Spine Pedicle : Report of Two Cases and Review of the Literature" Journal of Korean Neurosurgical Society = 대한신경외과학회지 44 (6): 389~391    
    6. 2008 "Midline Glioblastoma Multiforme With Bilateral Symmetric Cysts" Journal of Korean Neurosurgical Society = 대한신경외과학회지 43 (2): 105~108    
  • Koh, Eun-Jeong (26)

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