Basal temporal language area demonstrated by electricalstimulation

Abstract

We report on a 38-year-old patient with intractable complex partial seizures originating in the dominant left medial temporal region. In the work-up for seizure surgery, arrays of subdural electrodes were placed, and electrical stimulation revealed marked language interference in a 2 X 2-cm area in the left basal temporal fusiform gyrus (3.5 to 5.5 cm posterior to the temporal tip). Complete receptive and expressive aphasia, inability to repeat, agraphia, and alexia were elicited, but visual memory was preserved, and no constructional apraxia was noted. Stimulation of the basal temporal gyrus at lower stimulus intensities produced a relatively selective and severe anomia.

Aphasic seizures in patients with temporopolar and anterior temporobasal lesions: A video-EEG study

“…the epileptogenic zone at the anterior temporobasal cortex and two patients with left-sided temporal lesions eventually became seizure-free after surgery demonstrates that ictal aphasia can primarily originate in this brain area, instead of spreading from primary language areas (e.g., Wernicke's and Broca's areas). Supporting this observation, electrocortical stimulation of the BTLA, the area where the lesions described in this series were located, produces a wide range of speech manifestations in patients with epilepsy similar to that observed in our patients with left-sided lesions [1][2][3], The paucity of literature regarding our observations may be explained by several reasons. Firstly, when language is impaired during a seizure, assessing level of awareness is difficult, and alteration of consciousness is assumed in most cases.…”

“…However, accumulating evidence suggests that the temporal pole and the temporal basal area play an important functional role in the language system, which could account for specific features of seizures arising here. Electrophysiological studies demonstrated that surface electrical stimulation during epilepsy surgery of a basal temporal language area (BTLA) produces a range of speech disturbances [1][2][3]. A combination of neuroimaging and neuropsychological studies has subsequently improved our understanding of the functional role of these dominant anterior temporal lobe areas in language [4][5][6].…”

Differences in auditory processing of words and pseudowords: An fMRI study

“…As stated previously, the lpSTG, along with the inferior parietal region has been linked to a network that is responsible for lexical access [Luders, 1991;Luders et al, 1986]. There have been several researchers to hypothesize that lexical access is automatic.…”

Transcortical surgery for lateral ventricular tumors

“…Luders and coworkers 25,26 have described a basal language region in the inferior temporal lobe that is best R. G. Ellenbogen Preoperative MR image of a middle fossa, temporal horn primitive neural ectodermal tumor obtained in a 14-year-old girl. She presented with rapidly declining mental status and hemiparesis after suffering an intratumoral hemorrhage.…”