Lexical retrieval pre- and posttemporal lobe epilepsy surgery in a pediatric sample

• Word-finding ability declines in children/adolescents after left temporal lobectomy.
• Phonemic verbal fluency not susceptible to change following temporal lobectomy
• Outcome of children 8 years and older is comparable with that in the adult literature.
• Emphasis on incorporating findings into surgical planning and family counseling

PurposeThis study aimed to evaluate lexical retrieval, presurgery and postsurgery, among children and adolescents who had undergone temporal lobe resection for intractable epilepsy and to compare outcomes in patients whose surgery involved the left temporal lobe or the right temporal lobe.Materials and methodsA retrospective chart review identified 36 patients from a major pediatric epilepsy treatment center who had undergone temporal lobe resection (21 underwent left temporal lobe resection; 15 underwent right temporal lobe resection) for intractable epilepsy and who had completed neuropsychological testing that included a measure of confrontation naming (Boston Naming Test, BNT) and verbal fluency (Delis–Kaplan Executive Function System (D-KEFS) Fluency) prior to and after surgery. Linear mixed effects regression models were used to evaluate presurgery and postsurgery changes and to compare the left temporal lobe resection group with the right temporal lobe resection group.Principal resultsConfrontation naming performance declined after left, but not right, temporal lobe resection (p < 0.05). This effect was not documented for verbal fluency.Major conclusionsLeft temporal lobe resection for intractable epilepsy is associated with a decline in lexical retrieval. The risk of decline in specific language functions following surgery involving the left temporal lobe should be incorporated in the counseling of patients and families in decision-making with regard to surgery.