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Naming and recognizing famous faces in temporal lobe epilepsy

From the Department of Neurology (Drs. Glosser and Chiaravalloti, and A.E. Salvucci), University of Pennsylvania, Philadelphia; and Kessler Medical Rehabilitation Research/Education (Dr. Chiaravalloti), West Orange, NJ.

Address correspondence and reprint requests to Dr. Guila Glosser, Department of Neurology (Gates 3), University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104-4283; e-mail: glosser{at}mail.med.upenn.edu

Objective: To assess naming and recognition of faces of familiar famous people in patients with epilepsy before and after anterior temporal lobectomy (ATL).

Methods: Color photographs of famous people were presented for naming and description to 63 patients with temporal lobe epilepsy (TLE) either before or after ATL and to 10 healthy age- and education-matched controls.

Results: Spontaneous naming of photographed famous people was impaired in all patient groups, but was most abnormal in patients who had undergone left ATL. When allowed to demonstrate knowledge of the famous faces through verbal descriptions, rather than naming, patients with left TLE, left ATL, and right TLE improved to normal levels, but patients with right ATL were still impaired, suggesting a new deficit in identifying famous faces. Naming of famous people was related to naming of other common objects, verbal memory, and perceptual discrimination of faces. Recognition of the identity of pictured famous people was more related to visuospatial perception and memory.

Conclusions: Lesions in anterior regions of the right temporal lobe impair recognition of the identities of familiar faces, as well as the learning of new faces. Lesions in the left temporal lobe, especially in anterior regions, disrupt access to the names of known people, but do not affect recognition of the identities of famous faces. Results are consistent with the hypothesized role of lateralized anterior temporal lobe structures in facial recognition and naming of unique entities.

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