[Presurgical neuropsychological assessment in epilepsy: the Wada test]

Harefuah. 2000 Mar 15;138(6):440-4, 519.
[Article in Hebrew]

Abstract

37 candidates for epilepsy surgery underwent the intracarotid amytal procedure (IAP; also known as the Wada test) to determine hemispheric speech dominance and memory capacity. 31 demonstrated left hemisphere speech dominance, 2 showed evidence for bilateral language and 4 demonstrated right hemispheric language dominance. Our study supports a correlational relationship between handedness, lesion laterality and age of onset of seizures, as reported in earlier studies. Left-handed patients with a left hemisphere lesion whose seizures began to an early age had a strong tendency for reversed language dominance. Asymmetry of at least 20% in performing the memory test was taken as the cutoff score for demonstrating laterality of lesions. The asymmetry score correctly predicted laterality of lesions in all 28 patients; 6 did not have asymmetry scores and 3 were examined for language only. None of the patients who successfully passed the Wada memory test had any significant postsurgical memory deficits; 1 had transient reduction in verbal memory and 4 who did not pass the test were not operated on for this reason. Our results demonstrate the importance of the Wada test in determining cerebral speech dominance, in predicting post-surgical amnesia, and support its usefulness in predicting laterality of seizure focus in candidates for temporal lobectomy.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Amobarbital* / administration & dosage
  • Child
  • Dominance, Cerebral
  • Epilepsy, Temporal Lobe / physiopathology
  • Epilepsy, Temporal Lobe / psychology
  • Epilepsy, Temporal Lobe / surgery*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Injections, Intra-Arterial
  • Male
  • Memory
  • Middle Aged
  • Neuropsychological Tests*
  • Preoperative Care

Substances

  • Hypnotics and Sedatives
  • Amobarbital