[Presurgical neuropsychological assessment in epilepsy: the Wada test].
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.
Andelman
F
F
Functional Neurosurgery Unit, Tel Aviv-Sourasky Medical Center, Tel Aviv.
Neufeld
M
M
Reider-Groswasser
I
I
Kremer
U
U
Segev
Y
Y
Fried
I
I
D000293:Adolescent; D000328:Adult; D000654:Amobarbital / Q000008:administration & dosage; D002648:Child; D004292:Dominance, Cerebral; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007269:Injections, Intra-Arterial; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011300:Preoperative Care
D006993:Hypnotics and Sedatives; D000654:Amobarbital