Visual confrontation naming following left anterior temporal lobectomy: A comparison of surgical approaches

Change in visual confrontation naming was examined following left (speech d ominant) anterior temporal lobectomy (ATL) as a function of surgical techni que and patient characteristics. Two hundred seventeen patients with intrac table left temporal lobe epilepsy were selected according to standard crite ria across 8 centers, and combined into 4 surgical approaches to ATL: (a) t ailored resections with intraoperative mapping of eloquent cortex, (b) tail ored resections with extraoperative mapping, (c) standard resections with s paring of superior temporal gyrus, and (d) standard resections including ex cision of superior temporal gyms. Changes in visual confrontation naming we re examined with an index of reliable change derived from an independent sa mple of 90 nonsurgical patients with complex partial seizures. Results show ed significant decline in visual confrontation naming following left ATL, r egardless of surgical technique. Across surgical approaches, the risk for d ecline in visual confrontation naming was associated with a later age of se izure onset and more extensive resection of lateral temporal neocortex.