Presurgical Language Mapping in Patients With Intractable Epilepsy: A Review Study

Introduction: about 20% to 30% of patients with epilepsy are diagnosed with drug-resistant epilepsy and one third of these are candidates for epilepsy surgery. Surgical resection of the epileptogenic tissue is a well-established method for treating patients with intractable focal epilepsy. Determining language laterality and locality is an important part of a comprehensive epilepsy program before surgery. Functional Magnetic Resonance Imaging (fMRI) has been increasingly employed as a non-invasive alternative method for the Wada test and cortical stimulation. Sensitive and accurate language tasks are essential for any reliable fMRI mapping.  Methods: The present study reviews the methods of presurgical fMRI language mapping and their dedicated fMRI tasks, specifically for patients with epilepsy. Results: Different language tasks including verbal fluency are used in fMRI to determine language laterality and locality in different languages such as Persian. there are some considerations including the language materials and technical protocols for task design that all presurgical teams should take into consideration. Conclusion: Accurate presurgical language mapping is very important to preserve patients language after surgery. This review was the first part of a project for designing standard tasks in Persian to help precise presurgical evaluation and in Iranian PWFIE.