Cortical Language Areas and Plasticity in Pediatric Patients with Epilepsy: a Review

Publication date: Available online 12 October 2017
Source:Pediatric Neurology
Author(s): Naomi Chou, Sandra Serafini, Carrie Muh
Chronic injury to the brain from seizure activity is associated with decreased language skills in pediatric patients, as measured on neuropsychological tests for language function and academic achievement. This makes the study of language in patients with epilepsy clinically necessary. Functional magnetic imaging (fMRI) and direct electrical cortical stimulation (ECS) have been used to evaluate aspects of cortical language processing in healthy adults and in adults with epilepsy or other neurological insults. Results of these studies help to locate cortical language areas that are involved with modality-specific language processing (visual naming, auditory naming, sentence-completion, and repetition naming) and the neuroplasticity of language areas in the setting of neurological injury and reorganization. A better understanding of language processing contributes to a more efficient and efficacious electrical cortical stimulation mapping of language areas for patients with intractable epilepsy who are undergoing pre-resection evaluation. Most of the current literature on localization and reorganization of cortical language areas in the setting of epilepsy concerns the adult patient population, while the literature on pediatric patients is substantially lacking in comparison. This manuscript reviews the conclusions drawn thus far from Wada, magnetoencephalography, fMRI, and ECS language studies on types of language reorganization seen in pediatric patients with intractable temporal lobe epilepsy and the clinical factors associated with reorganization, and proposes future directions of research to further the academic and clinical understanding of language processing in pediatric patients.



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