Auditory naming and temporal lobe epilepsy

Patients with left (i.e. language-dominant) temporal lobe epilepsy (TLE) ty pically report word finding difficulties. However, these deficits are not r eliably detected with traditional visual object naming tests. We administer ed both visual and auditory naming tests to left and right TLE patients and normal controls. We hypothesized that an auditory naming test might be mor e sensitive since it better simulates the conditions under which word findi ng problems occur in daily living. The left TLE group obtained significantl y lower scores than other groups on auditory naming, whereas their performa nce on visual naming was indistinguishable from that of right TLE patients and normals. Furthermore, whereas cut-off scores on the auditory naming tas k predicted seizure focus laterality in 85% of patients, performance on the visual naming task predicted laterality in only 60% of patients. These fin dings suggest that compared with visual naming, as assessed in the present study, auditory naming may more accurately characterize and lateralize TLE- associated language dysfunction. These results also propose a more complex understanding of word retrieval that incorporates modality and contextual i nformation. (C) 1999 Elsevier Science B.V. All rights reserved.