Abstracts

Rationale: Epilepsy is increasingly recognized as a neurological condition that can have adverse cognitive and psychological effects. Despite aggressive medical treatment, about 35% of patients are diagnosed with medically refractory epilepsy and are candidates for surgical treatment. Patients with left temporal lobe epilepsy (LTLE) are thought to be at greatest risk for a decline in language function post-surgery. However, some data suggest patients with right TLE (RTLE) may also exhibit a decline in language function. The current study compares patients with LTLE and RTLE on pre-surgical verbal language tasks. Methods: The study included review of epilepsy patients completing a pre-surgical evaluation for medically refractory epilepsy. Participants: Fifty-four patients were identified that met study inclusion and exclusion criteria. There were 20 left TLE and 34 right TLE patients. Variables/Measure(s). All participants completed comprehensive neuropsychological evaluations, including the Boston Naming Test (BNT) and Controlled Oral Word Association Test (COWAT). Results: Pre-surgical data are presented. The mean age of the left TLE sample was 40 (SD= 12.1) with 12.6 years of education. The mean age of the right TLE group was 38 (SD= 13.9) with 14.5 years of education. Education and full scale IQ differed between groups and were used as covariates in all analyses. ANCOVA revealed significant differences in pre-surgical BNT performance between left and right TLE patients. Phonemic and semantic verbal fluency scores also differed, with left TLE patients performing significantly worse than right TLE patients. Comparisons to intra-carotid Amytal (Wada’s) test scores were generally consistent.Conclusions: These data further support observations that neuropsychology measures of language function can be helpful indices in lateralized epilepsy. Among the patients diagnosed with either TLE, the left TLE group scored significantly worse on measures of both naming and verbal fluency than the right TLE group. Comparisons with lesion on MRI and Wada’s test scores will be discussed.