Aphasia after hemispherectomy in an adult with early onset epilepsy and hemiplegia.
A 55 year old left handed man with left hemisphere subcortical encephalomalacia, seizures, language impairment, and right hemiparesis from a motor vehicle accident at age five was evaluated for epilepsy surgery. The patient continued to speak and followed commands during a left intracarotid amobarbital test (IAT). Left functional hemispherectomy resulted in expressive aphasia. Based on postoperative outcome, language was bilateral. The injury after primary development of language function, the predominantly subcortical lesion, and the late timing of surgical intervention well past development and plasticity may have been factors in the emergence of postoperative aphasia.
Loddenkemper
T
T
Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. loddent@ccf.org
Dinner
D S
DS
Kubu
C
C
Prayson
R
R
Bingaman
W
W
Dagirmanjian
A
A
Wyllie
E
E
D000063:Accidents, Traffic; D000368:Aged; D000654:Amobarbital; D001037:Aphasia / Q000209:etiology*; D002339:Carotid Arteries; D004827:Epilepsy / Q000209:etiology / Q000601:surgery*; D018757:GABA Modulators; D006429:Hemiplegia / Q000209:etiology* / Q000601:surgery; D038421:Hemispherectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009473:Neuronal Plasticity; D013997:Time Factors
D018757:GABA Modulators; D000654:Amobarbital