Methods of lateralization of language in pre-surgical assessments of children with intractable epilepsy

Abstract

In considering noninvasive alternatives to the Wada test, reviews of the adult literature on language lateralization have touted the possibilities and promises of functional magnetic resonance imaging for localizing language prior to surgery for intractable epilepsy. However, even as research continues to examine the benefits of pursuing a surgical treatment for intractable epilepsy in young children, the literature on alternative methods of language lateralization remains considerably less developed than the adult literature. In addition to functional magnetic resonance imaging, potential alternative methods include functional transcranical Doppler, magnetoencephalography, near infrared spectroscopy, and dichotic listening. This paper examines current research on the use of these alternative methods in order to provide an introduction to the clinical possibilities and challenges in using each method with children with the cognitive or behavioral limitations often associated with intractable epilepsy.