P.098 Usefulness of language mapping during cortical stimulation for presurgical planning in Stereo-encephalograph

Abstract

Background: Background: Language determination is a pivotal part of presurgical investigations. Presurgical cortical stimulation (CS) with language mapping (LM) in patients with intracranial recordings (SEEG) is a growing practice in some Comprehensive Epilepsy Centers. Methods: Methods: This retrospective, single center study included patients implanted with SEEG that underwent CS for LM in our Epilepsy Monitoring Unit. We describe frequencies, demographic characteristics of these patients and whether or not CS with LM was useful. Results: Results: From January 2015 to June2021, a total of 177 patients were implanted with SEEG and analyzed. 95 patients had CS and 44 of these had CS with LM. The mean age was 33 (ranging from 15-70). During LM, anomia was induced in 26 (58%), speech arrest in 22 (49%), paraphasic errors in 13 (29%), and hesitation in 9 (20%). LM results were recorded as influencing surgical decision in 7 (16%) patients, 4 (9%) did not undergo surgery due to expected language deficits and 3 (7%) proceeded with surgery due to an acceptable risk of language deficit. Conclusions: Conclusions: Cortical stimulation language mapping is useful for decision-making in presurgical evaluation and should be encouraged whenever involvement of language is suspected when determining the epileptogenic zone.