Crossed aphasia after right anterior temporal lobectomy. A case report.

The occurrence of crossed aphasia as a complication after temporal lobe epilepsy surgery is extremely rare. We report the case of a 47-year-old right-handed patient with drug-resistant mesial temporal lobe epilepsy (MTLE) who developed a transitory aphasic syndrome after a right temporal anterior lobectomy. This syndrome was characterized by anomia, poor verbal fluency, verbal perseveration, and verbal comprehension difficulties. He also showed writing difficulties, reading substitutions, and calculation task errors. The patient was regularly assessed with language tasks, and showed a spontaneous and progressive recovery of his symptoms, with remaining naming difficulties. We discuss the role that epileptogenic zone could play in cortical reorganization of the language systems.

A study of word finding difficulties in Spanish speakers with temporal lobe epilepsy.

It is well established that naming deficits can be found in temporal lobe epilepsy (TLE). The aim of this study was to determine in Spanish speakers with pharmacoresistant TLE the characteristics of subjective naming difficulties and to examine performance in a definition task and a picture task in left TLE and right TLE. We observed that almost one-third of patients report frequent and severe word finding problems during spontaneous speech. In naming tests, our patients exhibited delayed times for finding words. Even if the target word was identified and semantically activated, there was difficulty with lexical access, which improved when a phonetic cue was given. Left TLE patients derived a lower benefit from phonetic cues in accessing words, even when the word is known and recognized semantically. These findings were not related to any demographic or clinical characteristics analyzed. The fact that the only weakly lateralized variable has been a lexical access facilitation measurement could support a lexical access hypothesis for naming deficits in TLE.

The vascular dementia of Fabry's disease.

Fabry's disease, a rare X-linked disorder of glycosphingolipid metabolism, can present as an insidious dementia in middle or later life. This genetic disorder produces a deficiency of alpha-galactosidase A which results in the deposition of glycosphingolipids in blood vessel walls in the brain as well as in the kidney, heart, peripheral nerves, and other organs. Among the cerebrovascular manifestations of this disorder is a vascular dementia from involvement of multiple small penetrating blood vessels. Fabry's disease is a consideration in the workup of an otherwise unexplained vascular dementia, particularly in males less than 65 years of age.