Language lateralization of a bilingual person with epilepsy using a combination of fMRI and neuropsychological assessment findings

ABSTRACT

This report describes the findings of language functional magnetic resonance imaging (fMRI) in a left-handed Urdu and English speaker with right hemisphere-originating epilepsy and unclear language dominance. fMRI is a reliable method for determining hemispheric language dominance in presurgical planning. However, the effects of bilingualism on language activation depend on many factors including age of acquisition and proficiency in the tested language, and morphological properties of the language itself. This case demonstrates that completing fMRI in both spoken languages and interpreting the results within the context of a neuropsychological assessment are essential in arriving at accurate conclusions about language distribution in bilingual patients.

KEYWORDS:

• Epilepsy surgery
• bilingualism
• neuropsychological assessment
• language laterality
• functional MRI

Acknowledgements

The authors would like to express their thanks to John Fisk, Ph.D. and to Susan Rahey, Epilepsy Programme Coordinator, for editorial comments, and Carl Helmick for assistance with fMRI analysis. The fMRI protocols used in this case were based on the work of Mary Pat McAndrews, Ph.D. (Toronto Western Hospital).

Disclosure statement

Authors A.O., C.O. and M.S. have no conflict of interest to disclose.