MULTIPLE SUBPIAL TRANSECTIONS IN LANGUAGE CORTEX - EFFECTS ON LANGUAGE FUNCTIONS

Multiple subpial transections (MST) were made in language cortex in 13 patients with medically refractory partial epilepsy. Transections wer e made in posterior language cortex in 12 patients and in both anterio r and posterior language areas in 1. Eleven patients had additional re sective surgery in the anterior temporal (n = 10) or anterior temporal and frontopolar (n = 1) regions. Eleven of the 13 patients had at lea st 90% reduction in seizure frequency. Dysnomia was present >6 months postoperatively in 9 patients (mild, 6; moderate, 3). Other deficits i ncluded impaired memory (mild, 3; moderate, 1) and reading (mild, 2). We compared the postoperative neuropsychologic findings in 7 patients with MST and temporal lobectomy with those in 14 patients who underwen t only dominant temporal lobectomy. MST patients had significantly (p < 0.05) poorer postoperative naming, verbal fluency, and oral reading than patients with dominant temporal resections that spared language f unctions. MST in language areas can contribute to or cause language di sorders that persist >1 year postoperatively. (C) 1997 by Elsevier Sci ence Inc. All rights reserved.