NAMING ABILITY AFTER TAILORED RESECTION WITH LANGUAGE MAPPING IN PATIENTS WITH LEFT HEMISPHERE TUMORS PRESENTING WITH EPILEPSY
Abstract number :
2.153
Submission category :
Year :
2002
Submission ID :
2583
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Keith G. Davies, Gail L. Risse, John R. Gates. Neurosurgery, Associates, LTD, St. Paul, MN; Minnesota Epilepsy Group, PA[reg], of United Hospital and Children[ssquote]s Hospitals and Clinics, St. Paul, MN; Clinical Professor, Department of Neurology, Univ
RATIONALE: Temporal resection for non-lesion epilepsy in the left, language-dominant, hemisphere carries the risk of decline in post-operative naming ability, and the risk is associated with later epilepsy onset age and absence of hippocampal sclerosis. The objective of the present study was to examine naming outcome after resection with language mapping in patients presenting with epilepsy and left hemisphere tumors.
METHODS: The sample consisted of patients undergoing left hemisphere tailored resection of tumor and epileptogenic cortex after extraoperative language mapping and who had Boston Naming Test (BNT) evaluation pre- and 6-8 months post-operatively, and who had left hemisphere dominance for language by amobarbital testing. Reliable Change Index (RCI) (5 for BNT) was used as an indication of meaningful change.
RESULTS: Thirteen patients (5 male/8 female) met the criteria. Four had frontal and nine had temporal resection. Mean-age was 34-years and mean-epilepsy onset age was 25-years. Mean-BNT change for the frontal group was -1.25, and for the temporal group -11.67. For the frontal group one patient had a [gt]RCI decline in BNT, but for the temporal group, six (67%) had a [gt]RCI decline on the BNT. For the temporal group there was correlation between BNT decline and onset age (r=-0.8, p[lt]0.05).
CONCLUSIONS: Patients with temporal lesional epilepsy undergoing tailored resection were at risk for a decline in naming ability. Frontal resection patients do not show this risk. Late onset of seizures may be associated with greater decline.