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Brain, Vol. 117, No. 2, 255-265, 1994
© 1994 Oxford University Press

research-article

Multiple subpial transections in the language cortex

Orrin Devinsky, Kenneth Perrine, Blanca Vazquez, Daniel J. Luciano and Michael Dogali

Departments of Neurology and Neurosurgery, NYU School of Medicine and Hospital for Joint Diseases New York, USA

Correspondence to: Orrin Devinsky, Department of Neurology, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA

Multiple subpial transections (MST) were made in language cortex in three patients with medically refractory partial epilepsy. All patients were mapped with extra-operative stimulation using subdural grids over the dominant temporal, frontal and parietal convexity. Two patients had anterior temporal lobectomy and MST in posterior language cortex. One patient who had undergone a previous frontal tumour resection had only MST over the frontoparietal convexity, including frontal and parietal language areas. Both patients with MST in the posterior language cortex had postoperative language dysfunction, which had improved significantly by 9 months after surgery. The patient with MST in frontoparietal language areas had improved language functions immediately postoperatively. The two men with anterior temporal lobectomies and MST are seizure-free at 1 year follow-up and the woman with fronto-parietal MST has had a >70% reduction in seizure frequency at 1 year follow-up.

epilepsy; surgery; language; aphasia; electrical stimulation

Received September 15, 1993. Revised November 16, 1993. Accepted December 4, 1993.


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