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J Korean Neurol Assoc. 2006;24(5):428-434.
The Related Factors to Atypical Language Dominance in Patients with Epileptic Foci in the Left Hemisphere
In Jung Kim
Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea
좌측 반구에 간질 초점을 가진 환자에서 비전형적인 언어 우성 반구와 관련이 있는 요인
김인정, 이상암 강중구
울산대학교 의과대학 신경과학교실
Abstract
Background
Several studies have revealed the increased incidence of atypical language dominance in patients with left hemisphere epileptic foci. We retrospectively investigated the incidence and related factors for language dominance shift determined by intracarotid amobarbital procedure (IAP) in patients with left hemispheric epilepsies.
Methods
We included 222 epileptic patients with epileptic foci in left hemisphere whose language dominance was determined by IAP at Asan Medical Center from 1994 to 2004. The items on the language test in IAP included spontaneous speech (6 items), understanding (2 items), and repetition (2 items). Language lateralization index (LI) was computed according to the formula L=(Score IAP right-Score IAP left)/(Score IAP right+Score IAP left). Clinical information was obtained from medical records including age, gender, age at onset of epilepsy, duration of epilepsy, frequency of seizures, risk factors, onset age of risk factors, and lateralization of MRI or EEG.
Results
Of the 222 patients (male 110 patients, 49.5%), complete left language dominance was 142 patients (64.0%), and complete right hemispheric language dominance was 29 patients (13.1%). Seizure onset age, onset age of risk factors, handedness and MRI lesions (hippocampal atrophy or left extensive lesion) had statistically significant association with atypical language dominance. On a linear regression analysis, the significant predictors of the atypical language dominancy were handedness and left extensive lesion (R2=.64).
Conclusions
Atypical language dominancy in patients with left epileptic foci was highly correlated with non-right handedness and extensive lesion on the left hemisphere.KeyWords:Intracarotid amobarbital procedure, Language dominancy, Epilepsy, Handedness, MRI

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