Abstracts

Rationale: Naming decline is a well-known risk of (dominant) left temporal lobe resection for seizure control in adults. However, far less is known about the course of naming following epilepsy surgery in children. Whereas language is considered relatively stable when most adults with TLE undergo epilepsy surgery, the language skills of children are still developing, which potentially renders them more, or less, vulnerable to the cognitive effects of a temporal lobe resection. Methods: Subjects were 17 children (9 girls, mean age: 11.8, SD=2.7; age range: 7.5-15.8) with unilateral (9 left) seizure onset, who were tested pre- and postoperatively. The Visual Naming Test consists of 36 color photographs of familiar items, each on a white background, and the Auditory Naming Test consists of 36 descriptions of familiar items. Performance measures for both tests include Number Correct (within 20 sec), mean response time (RT), and Tip-of-the-tongue responses (i.e., items named in 2-20 seconds or after 20 seconds if named following a phonemic cue, e.g., "ha" for hammer). Paired t-tests for Left Hemisphere and Right Hemisphere groups assessed naming differences as a function of time (pre vs. postoperative). Results: Mean age (left: 11.6, SD=2.9; right 12.0, SD=2.6) and FSIQ (left: 93.6, SD=7.4; right: 90.1, SD=12.5) were comparable between left and right hemisphere patients. Repeated measures analysis revealed no significant changes in any of the naming scores in the Left Hemisphere group. By contrast, Right Hemisphere patients demonstrated improved performance in Auditory Naming accuracy (P = .03) and Response time (P = .02), yet no significant changes in Visual Naming performance. Conclusions: Unlike adults, and at odds with our hypothesis, children who underwent left hemisphere surgery did not exhibit naming decline. However, children who underwent right hemisphere surgery improved both in accuracy and response time when required to name objects based on verbal descriptions. These preliminary findings suggest that although left hemisphere surgery patients did not decline in naming, per se, that dominant hemisphere surgery might compromise aspects of verbal development or might interfere with benefits typically gained from practice on verbal measures. Funding: R01 NS 35140 (MH). Shire did not fund or contribute to this research.