False lateralization of language cortex on functional MRI after a cluster of focal seizures.
fMRI can define language cortex but its limitations are not yet fully understood. This article describes a child in whom fMRI falsely lateralized language cortex when performed after a cluster of left temporal lobe seizures. Multiple language tasks revealed no activation over the left temporal lobe despite a normal neurologic exam at the time of the study. A second fMRI performed 2 weeks later activated sites predominantly over the left, which were confirmed by extra-operative functional language mapping. fMRI may be unhelpful after frequent seizures.
Jayakar
Prasanna
P
Department of Neurology, Miami Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA. prasanna.jayakar@mch.com
Bernal
Byron
B
Santiago Medina
L
L
Altman
Nolan
N
D000293:Adolescent; D001931:Brain Mapping; D003951:Diagnostic Errors; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000503:physiopathology*; D007839:Functional Laterality; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D015203:Reproducibility of Results; D013702:Temporal Lobe / Q000503:physiopathology