Neuropsychology Review

, 21:240

Language Organization and Reorganization in Epilepsy


DOI: 10.1007/s11065-011-9180-z

Cite this article as:
Hamberger, M.J. & Cole, J. Neuropsychol Rev (2011) 21: 240. doi:10.1007/s11065-011-9180-z


The vast majority of healthy individuals are left hemisphere dominant for language; however, individuals with left hemisphere epilepsy have a higher likelihood of atypical language organization. The cerebral organization of language in epilepsy has been studied with invasive procedures such as Wada testing and electrical cortical stimulation mapping (ESM), and more recently, with noninvasive neuroimaging techniques such as functional magnetic resonance imaging (fMRI). Investigators have used these techniques to explore the influence of unique clinical features inherent in epilepsy that might contribute to the reorganization of language, such as location of seizure onset, age of seizure onset, and extent of interictal epileptiform activity. In this paper, we review the contribution of these and other clinical variables to the lateralization and localization of language in epilepsy, and how these patient-related variables affect the results from these three different, yet complementary methodologies. Unlike the abrupt language changes that occur following acute brain injury with disruption of established language circuits, converging evidence suggests that the chronic nature of epileptic activity can result in a developmental shift of language from the left to the right hemisphere or re-routing of language pathways from traditional to non-traditional areas within the dominant left hemisphere. Clinical variables have been shown to contribute to cerebral language reorganization in the setting of chronic seizure disorders, yet such factors have not been reliable predictors of altered language networks in individual patients, underscoring the need for language lateralization and localization procedures when definitive identification of language cortex is necessary for clinical care.


Epilepsy Language Language reorganization Language mapping 





Electrical Stimulation Mapping


functional Magnetic Resonance Imaging


Hippocampal Sclerosis


Magnetic Resonance Imaging


Medial temporal lobe epilepsy


Temporal lobe epilepsy

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.The Neurological InstituteColumbia University Medical CenterNew YorkUSA
  2. 2.JFK Medical Center/Center for Head InjuriesEdisonUSA