Improvement in naming assessment may rely on the addition of auditory naming in children with unilateral epilepsy, particularly by including response time into performance measures and reducing the influence of vocabulary. These findings were published in a recent edition of Neurology.

A total of 78 patients with unilateral epilepsy (age, 6-15 [mean age, 11.8±2.6] years) were enrolled and subsequently completed the Children’s Auditory Naming and Visual Naming Tests, Boston Naming Test, and other verbal and nonverbal tasks. Summary Score-All and Summary Score-Time were calculated, which used total correct responses <2 seconds — tip-of-the-tongue responses and total correct responses in <2 seconds — total correct responses in ≥2 seconds, respectively. In a multivariate analysis of variance, researchers compared test performance between the left and right hemisphere epilepsy groups. The Wechsler Intelligence Scale for Children-IV/V (n=61) or the 2-subtest Wechsler Abbreviated Scale of Intelligence (n=17) were used to obtain Full Scale IQ.

Children with left hemisphere epilepsy had significantly poorer auditory naming compared with children with right hemisphere epilepsy (P =.02). No differences were found between groups with regard to measures of visual naming, general intelligence, or other cognitive functions. A significant proportion of children had correctly classified seizure laterality when the investigators used auditory naming cutoff scores to distinguish between intact vs impaired performance. There was a 4.2-times higher odds for left hemisphere epilepsy than for right hemisphere epilepsy in children with poor auditory naming performance (95% CI, 1.4-11.7). In addition, the odds of left temporal lobe epilepsy were 11.3 times higher than for right temporal lobe epilepsy with poor auditory naming performance in patients with temporal lobe epilepsy.

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Limitations of the study included its small sample size and the inclusion of children with left and right hemisphere epilepsy who were relatively similar in age.

“In the context of epilepsy surgery,” the study investigators concluded, “results suggest that these children’s naming tests promise utility in lateralization of dysfunction associated with the region of seizure onset.”

Reference

Hamberger MJ, MacAllister WS, Seidel WT, et al. Noninvasive identification of seizure lateralization in children: name that thing. Neurology. 2019;92(1):e1-e8.