Symposia 1 Program Schedule
02/15/2024
09:00 am - 10:30 am
Room: West Side Ballroom - Salon 1
Symposia 1: Bilingualism and Culture in Epilepsy Across the Lifespan: A Multidimensional Perspective
Simposium #4
Electrical stimulation mapping in historically underserved populations with epilepsy: A patient-centric approach
Heidi Bender, Weill Cornell Medicine, New York, United States
Category: Epilepsy/Seizures
Keyword 1: epilepsy / seizure disorders
Objective:
The ability to localize eloquent cortices during pre-surgical planning and surgical
intervention is often accomplished by strategic, systematic evaluation during electrical
stimulation mapping (ESM). ESM is designed to suppress cortical activity in order to functionally
ablate a discrete area and observe the resultant disruption, thus maximizing the preservation of
neurocognition post-resection. Yet, failure to establish a clinically-meaningful, linguistically- and
culturally-appropriate set of test items will be unlikely to reliably capture the nuanced information
which is the bedrock of this ‘high stakes’ study.
Participants and Methods:
Case studies will discuss the similarities and differences between intra- and extra-
operative functional mappings of patients who are non-U.S.-born, non-native English-speaking,
with limited exposure to U.S.-majority culture and education. Included patients are: monolingual
Russian- and Spanish-speakers (89- and 43 years of age, respectively), a bilingual pediatric
patient (14 years of age), and a predominantly Hausa-speaking patient residing abroad (62
years of age).
Results:
Though selected paradigms should be well-validated and have established correlation
to desired anatomical targets, they should also reflect a patient’s own unique socio-cultural,
linguistic, and educational histories.
Conclusions:
Extensive pre-mapping sessions are critical in developing mapping paradigms
which reflect and honor patients’ unique experiences and humanity. Once these parameters are
established in collaboration with the patient and neurosurgeon, items should be thoroughly
piloted to ensure that any errors during stimulation are secondary to the effects of the electric
current, rather than due to linguistic or cultural factors. The clinical value of functional mappings
must equally weigh the neuroanatomical, functional and experimental variability of each
individual patient.
| 
