Lateralization of Temporal Lobe Epilepsy and Learning Disabilities, as Defined by Disability‐related Civil Rights Law

Abstract

Summary:Purpose: Epilepsy research has identified higher rates of learning disorders in patients with temporal lobe epilepsy (TLE). However, most studies have not adequately assessed complex functional adult learning skills, such as reading comprehension and written language. We designed this study to evaluate our predictions that higher rates of reading comprehension, written language, and calculation disabilities would be associated with left TLE versus right TLE.Methods: Reading comprehension, written language, and calculation skills were assessed by using selected subtests from the Woodcock-Johnson Psycho-Educational Tests of AchievementRevised in a consecutive series of 31 presurgical patients with TLE. Learning disabilities were defined by one essential criterion consistent with the Americans with Disabilities Act of 1990. Patients had left hemisphere language dominance based on Wada results, left or right TLE based on inpatient EEG mon-

Learning Disorders in Epilepsy

“…However, the role of a brain lesion or dysfunction in causing LD is not clear; some authors found worse academic performances in symptomatic epilepsies than in cryptogenic or idiopathic epilepsies (28); in contrast, other authors did not find a significant difference between the groups, possibly because in the cryptogenic epilepsy an underlying brain abnormality has not been found but is nevertheless present (29). There is concordance in the literature on the role of the dominant hemisphere in LD, especially in reading comprehension and in calculation disabilities (6). Patients with temporal lobe epilepsy have worse academic performance, especially in verbal functions, when the left hemisphere is involved (6,29).…”

“…Children present with low IQ scores because of epilepsy, medication, or other related problems, although they have normal underlying intelligence. For example, in partial epilepsies, after surgery, patients sometimes have improved IQ scores (6). Moreover, children with LD often present with behavioral and psychological disorders which may be confounding factors when attempting to measure true IQ scores.…”

“…Multiple factors have been associated with learning deficits in epilepsy, such as various psychosocial, medication, and epilepsy‐related factors (6). Older children have a higher prevalence of LD than younger children (27).…”

Child-Onset Idiopathic Seizures and Specific Learning Disability: Comorbidities in Adults

“…Similarly, neuropsychologically significant relationships between ongoing seizures and mental decline have been established in a number of longitudinal studies (see Dodrill, 2004). Moreover, there is a long history of concern about the differing effects of seizure type, potential effects of anticonvulsant medications, and psychological factors that can result in further learning and adaptive challenges (Bennett, 1992;Butterbaugh, Olejniczak, Rogues, Costa, Rose, Carey, Thomson, & Skinner, 2004;Ferrari, Verbanac, & Kane, 1998;Paradiso, Hermann, Blumer, Davies, & Robinson;Schubert, 2005).…”

“…One recent study exemplifies the interaction of some of these issues. In a sample of 31 presurgical patients with temporal lobe epilepsy (TLE), Butterbaugh et al (2004) reported less than 10% of adults with right TLE focus manifested LD, while 75% with left TLE had at least one area of learning disability.…”