Objective:

To clarify language lateralization differences in epilepsy patients with left-sided epileptogenic foci compared to healthy individuals and to construct a laterality index–activation map scheme.

Approach:

Key Findings:

• Non-classical language dominance was higher in epilepsy patients (69.4%) compared to healthy controls (45.5%, P=0.024).
• Wernicke's area showed a higher shift in dominance (81.8%) compared to Broca's area (50.0%).
• Laterality index–activation map consistency was 83.3% (Kappa=0.586) and regional LI consistency was 75.0% (Kappa=0.40).
• The left Broca's area retained core language function, while the left Wernicke's area showed significant functional impairment.

Interpretation:

Limitations:

• The study is retrospective and may have inherent biases.
• Sample size may limit the generalizability of the findings.

Conclusion:

The combined laterality index–activation map scheme reliably supports preoperative language lateralization.

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