Cortical localization of finger spelling and oral language: A case study

Finger spelling of letters and words was mapped by means of the cortical stimulation procedure in a hearing patient undergoing a left dominant anterior temporal lobe resection for relief of a seizure disorder. Finger spelling was disrupted at five sites: three overlapping with one or more oral language functions at sites in the classical posterior language area, two relating only to finger spelling in the anterior temporal region. Following the resection which included these latter sites, both short- and long-term postoperative deficits in finger spelling are described. Implications for the organization of manually based communication behavior in the left hemisphere are discussed.