Sensory cortical tongue representation in man

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✓ Extensive data on cortical tongue representation were analyzed in 100 patients who underwent craniotomy and cortical mapping by electrical stimulation for surgical treatment of epilepsy. As noted in the literature, the tongue is extensively represented within the central nervous system with a highly organized sensorimotor system and the data from this study corroborate a large cortical representation of the human tongue over the postcentral gyrus. The tongue was found to have a clear somatotopic organization over the postcentral area and to be represented bilaterally to a significant degree. Furthermore, the tongue appears to have an asymmetrical sensory cortical representation, as cerebral dominance for speech is more extensively represented on the dominant hemisphere. Cortical tongue mapping has proved extremely useful in determining the point of junction of the central and Sylvian sulci, a crucial landmark during surgical cortical resections.

Article Information

Address reprint requests to: André Olivier, M.D., Department of Neurology and Neurosurgery, Montreal Neurological Institute, 3801 University Street, Suite 107, Montreal, Quebec H3A 2B4, Canada.

© AANS, except where prohibited by US copyright law.

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Figures

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    Operative photograph of the left hemisphere. The white thread delineates the planned temporal resection and the letters show abnormality in the electrocorticogram. All stimulation responses (numbers) were obtained at 1.5 volts. 1: Patient felt something in the right lower lip. 2: He felt tingling on the right side of the tongue, anteriorly. 3: Tingling was noted further back on the tongue. 4: The same feeling was located slightly further back on the right side of the tongue. 5: The same response was felt a bit further back. 7: The same response was obtained further back on the tongue. 8: The same response was felt at the back of the tongue on the right side. 10: There was forward movement of the tongue and contraction of the lips to the right. 13: The patient exhibited arrest in counting.

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    Upper Left: All valid tongue motor responses obtained from both hemispheres have been transferred to a left hemisphere diagram. Thirty-four responses were precentral; 11 were postcentral. Upper Right: All valid tongue sensory responses obtained from both hemispheres have been transferred to a left hemisphere diagram. Five responses were precentral and 202 were postcentral. Lower: Diagram showing dispersion over the postcentral gyrus of all valid tongue sensory responses obtained from both hemispheres, transferred to a left hemisphere diagram. Numbers indicate quantity of responses obtained as measured by distance in centimeters from the Sylvian fissure.

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    Somatotopic localization of tongue sensory responses from both SSI areas, transferred to a left hemisphere diagram and showing the pattern of organization.

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    Upper Left: Sensory tongue responses from the dominant hemisphere in 49 patients have been transferred to a left hemisphere diagram. Upper Right: Sensory tongue responses from the nondominant hemisphere in 51 patients have been transferred to a left hemisphere diagram. Lower: Histogram of the dispersion and location of sensory tongue responses from both dominant and nondominant hemispheres related to distance from the Sylvian fissure.

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    Summary of motor and sensory tongue responses in 100 patients.

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