Determination of the dominant language hemisphere by functional MRI i n patients with temporal lobe epilepsy

Objective To determine the dominant language hemisphere in patients with intractable tempo ral lobe epilepsy before surgical treatment by using functional MRI (fMRI). Methods Twelve patients underwent fMRI. Among them, 4 patients also underwent the Wada test. Anterior temporal lobectomy was performed on patients with epileptic focu s on the non- dominant hemisphere, and selective amygdalo- hippocampectomy on pa tients with epileptic focus on the dominant hemisphere. ResultsTen patients had left dominance, and 2 right dominance. The fMRI results were c oncordant with Wada test results in the 4 patients who accepted the Wada test. Seven patients underwent anterior temporal lobectomy, and 5 underwent selective amygdalo- hippocampectomy. There was no post- operative dysphasia. Conclusion fMRI is an alternative method of noninvasive functional mapping for language dom inance in patients with temporal lobe epilepsy.