Atypical language in lesional and nonlesional complex partial epilepsy

W. D. Gaillard, M. M. Berl, E. N. Moore, E. K. Ritzl, L. R. Rosenberger, S. L. Weinstein, J. A. Conry, P. L. Pearl, F. F. Ritter, S. Sato, L. G. Vezina, C. J. Vaidya, E. Wiggs, C. Fratalli, G. Risse, N. B. Ratner, G. Gioia, W. H. Theodore

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


OBJECTIVE: We investigated the relationship between partial epilepsy, MRI findings, and atypical language representation. METHODS: A total of 102 patients (4 to 55 years) with left hemisphere epileptogenic zones were evaluated using three fMRI language tasks obtained at 1.5 or 3T with EPI BOLD techniques: verbal fluency, reading comprehension, and auditory comprehension. fMRI maps were visually interpreted at a standard threshold and rated as left or atypical language. RESULTS: Atypical language dominance occurred in 30 patients (29%) and varied with MRI type (p < 0.01). Atypical language representation occurred in 36% (13/36) with normal MRI, 21% (6/29) with mesial temporal sclerosis, 14% (4/28) with focal cortical lesions (dysplasia, tumor, vascular malformation), and all (6/6) with a history of stroke. Multivariate logistic regression analysis found handedness, seizure onset, and MRI type accounted for much of the variance in language activation patterns (χ = 24.09, p < 0.01). Atypical language was more prevalent in patients with early seizure onset (43.2%, p < 0.05) and atypical handedness (60%, p < 0.01). None of the three clinical factors were correlated with each other (p > 0.40). Patients with atypical language had lower verbal abilities (F = 6.96, p = 0.01) and a trend toward lower nonverbal abilities (F = 3.58, p = 0.06). There were no differences in rates of atypical language across time, age groups, or MRI scanner. CONCLUSION: Early seizure onset and atypical handedness, as well as the location and nature of pathologic substrate, are important factors in language reorganization.

Original languageEnglish (US)
Pages (from-to)1761-1771
Number of pages11
Issue number18
StatePublished - Oct 2007

ASJC Scopus subject areas

  • Clinical Neurology


Dive into the research topics of 'Atypical language in lesional and nonlesional complex partial epilepsy'. Together they form a unique fingerprint.

Cite this