Identification of distinct and overlapping cortical areas for bilingual naming and reading using cortical stimulation. Case report.

A bilingual pediatric patient who underwent tumor resection was mapped extraoperatively using cortical stimulation to preserve English and Hebrew languages. The authors mapped both languages by using 4 tasks: 1) English visual naming, 2) Hebrew visual naming, 3) read English/respond Hebrew, and 4) Hebrew reading. Essential cortical sites for primary and secondary languages were compared, photographically recorded, and plotted onto a schematic brain of the patient. Three types of sites were found in this patient: 1) multiuse sites (multiple tasks, both languages) in frontal, temporal, and parietal areas; 2) single-task sites (1 task, both languages) in postcentral and parietal areas; and 3) single-use sites (1 task, 1 language) in frontal, temporal, and parietal areas. These results lend support to the concept that bilingual patients can have distinct cortical representations of each language and of different language tasks, in addition to overlapping or shared sites that support both languages and multiple tasks.