title: Diagnostic significance of Wada procedure in very young children and children with developmental delay.
abstract: Localization of vital components of neurological functioning has to be performed before epilepsy surgery can be considered in children with intractable epilepsy. This study reports the experience with the Wada procedure in very young children and/or developmentally delayed children with an a priori considerable chance of failing the procedure. The aim of this study was to indicate the applicability of this procedure in this patient group. The Wada procedure is described in 16 children under 10 years of age and/or have intelligence quotient scores below 50 and/or are critically ill and/or are behaviourally disturbed. Information on motor, language and memory functioning is obtained in respectively 13/15, 9/13, and 5/11 children. Nine children underwent epilepsy surgery without postoperative impairment of neurological functioning. In five children epilepsy surgery was not performed because of the results of the Wada procedure or the lack of information during the Wada procedure. One child became seizure-free before surgery. Even in very young, developmentally delayed or behaviourally disturbed children, the Wada test can provide important information with respect to the decision pro or contra epilepsy surgery.
authors.affiliation: Department of Child Neurology, University Medical Centre, Utrecht, The Netherlands. f.e.jansen@neuro.azu.nl
authors.forename: Floor E
authors.initials: FE
authors.lastname: Jansen
authors.forename: Aag
authors.initials: A
authors.lastname: Jennekens-Schinkel
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Van Huffelen
authors.forename: W M Cees
authors.initials: WM
authors.lastname: Van Veelen
authors.forename: C Peter
authors.initials: CP
authors.lastname: Van Rijen
authors.forename: Willem C J
authors.initials: WC
authors.lastname: Alpherts
authors.forename: Jan
authors.initials: J
authors.lastname: Vermeulen
authors.forename: Onno
authors.initials: O
authors.lastname: Van Nieuwenhuizen
mesh_terms: D000654:Amobarbital; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis; D002658:Developmental Disabilities / Q000150:complications*; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D007839:Functional Laterality / Q000502:physiology; D018757:GABA Modulators; D006801:Humans; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
chemical_list: D018757:GABA Modulators; D000654:Amobarbital