Speech recognition impairments in patients with intractable right temporal lobe epilepsy.
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.
Boatman
Dana F
DF
Department of Neurology, John Hopkins School of Medicine, Baltimore, Maryland 21287, USA. dboatma@jhmi.edu
Lesser
Ronald P
RP
Crone
Nathan E
NE
Krauss
Gregory
G
Lenz
Frederick A
FA
Miglioretti
Diana L
DL
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
D000654:Amobarbital