functional magnetic resonance imaging assessment of language;
Wada testing;
electrocortical stimulation;
epilepsy;
D O I:
10.1016/j.yebeh.2003.08.002
中图分类号:
B84 [心理学];
C [社会科学总论];
Q98 [人类学];
学科分类号:
03 ;
0303 ;
030303 ;
04 ;
0402 ;
摘要:
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. (C) 2003 Elsevier Inc. All rights reserved.