Word-finding deficits persist after left anterotemporal lobectomy

Archives of Neurology
J Langfitt, R Rausch

Abstract

To determine the incidence and extent of exacerbation of word-finding difficulty following anterotemporal lobectomy and to identify predictors of change. Case-series study of qualitative and quantitative changes in confrontation naming ability before surgery and 1 year after surgery. Stepwise multiple regression analysis of predictors of postoperative naming change. A university epilepsy surgery program. Fifty-nine consecutive patients. Standard, en bloc anterotemporal lobectomy. Raw scores and types of errors on the 85-item Boston Naming Test. A significant exacerbation of word-finding difficulty was noted that persisted at least 1 year after surgery in 25% of patients with left, speech-dominant anterotemporal lobectomy (Laterality x Time interaction [F = 24.5; P < .0005]). "Tip-of-the-tongue"-type errors were most frequent (F = 54.66; P < .001), as opposed to paraphasic-type errors seen more frequently among patients with aphasia or dementia. Word-finding decline was worse among patients who underwent a left anterotemporal lobectomy and who were left-hemisphere speech dominant, older, or evaluated earlier in the postoperative course. Significant, persisting worsening of word-finding difficulties is not a rare consequence of a...Continue Reading

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