Multiple subpial transections in language cortex: Effects on language functions

Multiple subpial transections (MST) were made in language cortex in 13 patients with medically refractory partial epilepsy. Transections were made in posterior language cortex in 12 patients and in both anterior and posterior language areas in 1. Eleven patients had additional resective surgery in the anterior temporal (n = 10) or anterior temporal and frontopolar (n = 1) regions. Eleven of the 13 patients had at least 90% reduction in seizure frequency. Dysnomia was present >6 months postoperatively in 9 patients (mild, 6; moderate, 3). Other deficits included impaired memory (mild, 3; moderate, 1) and reading (mild, 2). We compared the postoperative neuropsychologic findings in 7 patients with MST and temporal lobectomy with those in 14 patients who underwent only dominant temporal lobectomy. MST patients had significantly (p < 0.05) poorer postoperative naming, verbal fluency, and oral reading than patients with dominant temporal resections that spared language functions. MST in language areas can contribute to or cause language disorders that persist >1 year postoperatively. (C) 1997 by Elsevier Science Inc. All rights reserved.