title: Speech recognition impairments in patients with intractable right temporal lobe epilepsy.
abstract: OBJECTIVE
  To evaluate speech recognition in patients with focal intractable epilepsy and surgical resections in the nondominant (right) hemisphere.
  
  
  METHODS
  Speech recognition was tested prospectively, under different listening conditions, in 22 patients with right temporal lobe (11 patients) or extra-temporal lobe epilepsy. All were left-hemisphere dominant for language on preoperative intracarotid sodium amobarbital testing.
  
  
  RESULTS
  All patients demonstrated normal auditory recognition of words and environmental sounds before and after surgery. However, when real-world listening conditions were simulated by using acoustically degraded (filtered) words, patients with temporal lobe epilepsy performed significantly worse than patients with frontal or parietooccipital lobe epilepsy before and after surgery (p<0.0001).
  
  
  CONCLUSIONS
  Patients with intractable right temporal lobe epilepsy are at risk for speech recognition impairments in real-world listening environments, independent of surgery. The impact of speech recognition difficulties on verbal communication, coupled with the prevalence of adverse listening environments, underscores the importance of testing speech recognition under different listening conditions in patients with intractable right temporal lobe epilepsy.
authors.affiliation: Department of Neurology, John Hopkins School of Medicine, Baltimore, Maryland 21287, USA. dboatma@jhmi.edu
authors.forename: Dana F
authors.initials: DF
authors.lastname: Boatman
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Lesser
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Crone
authors.forename: Gregory
authors.initials: G
authors.lastname: Krauss
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Lenz
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
mesh_terms: D000293:Adolescent; D000328:Adult; D000654:Amobarbital / Q000494:pharmacology; D001037:Aphasia / Q000139:chemically induced; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology / Q000601:surgery; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006311:Hearing Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007802:Language; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care; D011446:Prospective Studies; D013060:Speech / Q000187:drug effects / Q000502:physiology; D013063:Speech Discrimination Tests / Q000706:statistics & numerical data*; D013702:Temporal Lobe / Q000503:physiopathology* / Q000601:surgery
chemical_list: D000654:Amobarbital