ANTERIOR TEMPORAL LANGUAGE AREAS IN PATIENTS WITH EARLY-ONSET OF TEMPORAL-LOBE EPILEPSY

Eighteen consecutive patients undergoing dominant temporal lobectomy u nderwent preoperative cortical stimulation for language localization. Patients with naming deficits on anterior (4.5 cm from the temporal po le) temporal lobe stimulation had earlier seizure onset vs those witho ut such deficits (5.8 yr vs 12.9 yr; p < 0.04). There was a similar tr end for reading errors (6.3 yr vs 12.4 yr; p < 0.052). Resections alwa ys spared at least 1 cm anterior to any language area. There was no si gnificant difference in postoperative neuropsychological tests between patients with and without anterior language representation. Early ons et of dominant temporal lobe seizure foci leads to a more widespread o r atypical distribution of language areas. Individual variability shou ld be considered in epilepsy surgery to reduce postoperative language deficits.