Functional MRI reveals an interhemispheric dissociation of frontal and temporal language regions in a patient with focal epilepsy

We report the case of a patient with frontal lobe epilepsy in whom the Wada test failed to lateralize representation of language (fluent speech was observed after amobarbital injection on both the right and left side). Functional magnetic resonance imaging (fMRI) during a lexical processing task rev...

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Bibliographic Details
Published in:Epilepsy & behavior 2003-12, Vol.4 (6), p.776-780
Main Authors: Baciu, M.V., Watson, J.M., McDermott, K.B., Wetzel, R.D., Attarian, H., Moran, C.J., Ojemann, J.G.
Format: Article
Language:English
Subjects:
Adult
Brain Mapping
Electric Stimulation
Electric Stimulation - methods
Electrocortical stimulation
Epilepsies, Partial
Epilepsies, Partial - pathology
Epilepsies, Partial - physiopathology
Epilepsy
Frontal Lobe
Frontal Lobe - pathology
Functional Laterality
Functional magnetic resonance imaging assessment of language
Humans
Language
Language Tests
Life Sciences
Magnetic Resonance Imaging
Magnetic Resonance Imaging - methods
Male
Neurons and Cognition
Temporal Lobe
Temporal Lobe - pathology
Wada testing
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Summary:We report the case of a patient with frontal lobe epilepsy in whom the Wada test failed to lateralize representation of language (fluent speech was observed after amobarbital injection on both the right and left side). Functional magnetic resonance imaging (fMRI) during a lexical processing task revealed an atypical organization of language represented by an interhemispheric dissociation of language regions with a right frontal dominance and a left temporal dominance. Consistent with the fMRI results, the patient’s ability to name pictures was not reliably impaired by electrocortical stimulation (ECS) of left frontal cortex. The findings from Wada, fMRI, and ECS were confirmed by a lack of language impairment after left frontal lobectomy for seizures. This case illustrates that fMRI can precisely map cortical language networks in epileptic patients and that fMRI may be used to help interpret laterality results provided by the Wada procedure.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2003.08.002