Montreal Neurological Institute, Neurosurgery, Montreal/Quebec, Canada

AIM: To provide information related to atypical language activations (right or bilateral) in positron emission tomography in patients with left clear-cut hippocampal sclerosis. MATERIAL and METHODS: Twelve right-handed patients who had been operated on left-sided hippocampal sclerosis and 12 right-handed normal subjects were included and the synonym generation task was used for evaluation of language lateralization. RESULTS: Atypical language activations were frequently found in the patients compared to the controls. A total of 3 (25%) subjects in the controls showed atypical activations: 2 bilateral with right and 1 bilateral with left-sided activations. There were no clear rightsided Broca activations in the control group but almost 25% of the patients showed clear right-sided Broca activations. In the patients the incidence of atypical language activations was 91.6% (11 patients). CONCLUSION: From the present study, it is clear that functional reorganization of the language-related neuronal network is modified in patients with left hippocampal sclerosis. Although the lesion is far from the primary language-related areas, atypical language lateralization is common in these patients and this should be considered in preoperative period.