Investigation of the reorganisation of language and verbal memory systems in chronic temporal lobe epilepsy.

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Part of the brain, the left temporal lobe, is important in the comprehension of language. The front (anterior) and inner (medial) part of the temporal lobe is sometimes removed to treat a form of epilepsy known as temporal lobe epilepsy (TLE). There is always concern that the operation may affect the patient‘s language and memory. However, repeated epileptic activity over years may result in reorganisation of the normal systems. If true, such evidence would be important both clinically and for theories about normal language organisation. Surgical removal of the anterior left temporal lobe usually causes little disturbance of language function, and some regard this as evidence that this part is not involved in language. However, other evidence, both from brain imaging studies on normal subjects and from patients with a type of dementia, suggests that this is not the case, and that normal function cannot be inferred from the outcome of therapeutic removal of brain tissue in epileptic patients. Further, language is the mental product of interactions between widely distributed brain regions, and we will investigate whether chronic epilepsy results in reorganisation of these connections as an adaptation. Therefore, this study addresses both theoretical and practical clinical issues.