Determination of the dominant language hemisphere by functional MRI in patients with temporal lobe epilepsy

Abstract:Objective To determine the dominant language hemisphere in patients with intractable temporal lobe epilepsy before surgical treatment by using functional MRI (fMRI). Methods Twelve patients underwent fMRI. Among them, 4 patients also underwent the Wada test. Anterior temporal lobectomy was performed on patients with epileptic focus on the non-dominant hemisphere, and selective amygdalo-hippocampectomy on patients with epileptic focus on the dominant hemisphere.Results Ten patients had left dominance, and 2 right dominance. The fMRI results were concordant with Wada test results in the 4 patients who accepted the Wada test. Seven patients underwent anterior temporal lobectomy, and 5 underwent selective amygdalo-hippocampectomy. There was no post-operative dysphasia. Conclusion fMRI is an alternative method of noninvasive functional mapping for language dominance in patients with temporal lobe epilepsy.