LANGUAGE FUNCTION AFTER TEMPORAL LOBECTOMY WITHOUT STIMULATION MAPPING OF CORTICAL FUNCTION

We studied 95 patients who underwent standard anterior temporal lobect omy (ATL) without stimulation mapping of language areas, using neurops ychological parameters of language function preoperatively and 1 year postoperatively [Boston Naming Test and Verbal Fluency, and the Inform ation, Comprehension, Arithmetic, Similarities, Digit Span, and Vocabu lary subtests of the Wechsler Adult Intelligence Scale (WAIS)]. Verbal IQ (VIQ), Performance IQ (PIQ), Full-Scale IQ (FSIQ), and Verbal Devi ation Quotient were also evaluated, as were parameters of memory funct ion. All patients had hemisphere dominance for language assessed by an intracarotid amytal test. Fifty-three patients had a left dominant (L HDL) ATL with a mean extent of lateral resection of 4.8 cm, and 10 had a left ATL with right or mixed hemisphere dominance (RHDL, MDL). Thir ty-two patients had a right nondominant ATL. Seizure outcome was 57 an d 59% seizure-free for LHDH and right nondominant group, respectively, 1 year after operation. Comparison of preoperative scores showed the LHDL group to have significantly lower scores than the right nondomina nt group for several parameters of language function and memory. The g roup undergoing left dominant ATL showed no significant loss of langua ge function postoperatively and actually showed gains in many paramete rs. Standard ATL without stimulation mapping of language areas and wit h conservative lateral resection is safe for long-term language functi on. In addition, evidence shows preexisting language dysfunction in pa tients undergoing left dominant ATL.