LANGUAGE BEFORE AND AFTER TEMPORAL LOBECTOMY - SPECIFICITY OF ACUTE CHANGES AND RELATION TO EARLY RISK-FACTORS

We evaluated language functions in 154 patients with left hemisphere s peech dominance undergoing anterior temporal lobectomy (ATL). Measures of phonemic and semantic fluency, confrontation naming, repetition, c omprehension, and reading were administered before and 3 weeks postope ratively. Patients were grouped by focus (left, LT; right, RT) and pre sence of early risk factors for development of seizures (ER, early ris k, less than or equal to 5 years; NER, no early risk): (LT-ER, n = 45; RT-ER, n = 49; LT-NER, n = 27; RT-NER, n = 33). Preoperatively, the L T group showed a selective naming deficit as compared with the RT grou p. Postoperatively only the LT-NER group showed significant overall de cline in language. For this group, the change was attributable to a se lective decline in naming as compared with other functions. These data indicate that there is a specific risk to naming after dominant ATL f or adult temporal lobe epilepsy (TLE) patients with a left hemisphere focus and the absence of an early risk factor for the development of s eizures.