Abstracts

Rationale: Resection of epileptogenic zone involving the supplementary motor area (SMA) can result in transient contralateral hemiplegia or difficulty in action starting. In the dominant hemisphere verbal deficits could be presented after surgery in some cases. That were called SMA syndrome. Some literature described that verbal deficits condition might be last a long duration. That caused academic and social difficulties. The complication should be recognized for the prediction and assessment of deficits after surgical intervention involving this region. In the present study, we report three cases of adult female who presented with postoperative verbal deficits. Followed actively rehabilitation therapy they almost completely resolved in 1-3 months. Methods: All the three patients were over 20 years old right-handed female with normal neurological findings. The epileptogenic zone were localized according to the clinical presentation,MRI,PET,MEG,and SEEG recordings. Functional brain mapping was performed by cortical stimulation through SEEG electrodes. The resection area involving the posterior portion of the superior frontal gyrus (SMA), the middle portion of the cingulate gyrus, and the white matter underlying these areas were resected as the epileptogenic zones. Verbal comprehension and verbal motor test were involved. All the three patients received rehabilitation therapy three days later after surgery. Results: All the three patients suffered verbal impaired as well as right hemiparesis immediately after surgery. In two of them complete mutism appeared immediately after surgery. Spontaneous speech of one or two words could be done approximately 3 days later. Grammatically correct sentences gradually increased in 1 month. The verbal deficits and the right hemiparesis almost resolved in 3 months. The patient 3 had no spontaneous speech and could not answer questions (she could understand the questions showed by hands sign), while she could repeat simple words (e.g. count numbers, today is Monday) following others speaking. The verbal disturbances persisted a week, and gradually recovered in a month. Conclusions: Verbal deficits are common besides the hemiparesis after resection of SMA in dominant hemisphere in adult patients. Unusually the deficits can be resolved in 1-3 months after actively rehabilitation therapy. Funding: We did not receive any funding in support of this abstract.