title: Wada memory performance predicts seizure outcome after epilepsy surgery in children.
abstract: OBJECTIVE
  Wada memory asymmetries were examined in children from four comprehensive epilepsy surgery centers who subsequently underwent epilepsy surgery to determine whether Wada memory performance could predict degree of seizure relief in children.
  
  
  METHODS
  One hundred fifty-six children (between ages 5 and 16 years) with intractable epilepsy underwent Wada testing before resective epilepsy surgery (93 within the left hemisphere, and 63 within the right hemisphere). Memory stimuli were presented soon after intracarotid amobarbital injection, and recognition memory for the items was assessed after return to neurologic baseline. Eighty-eight children underwent unilateral temporal lobe resection, and 68 had extratemporal lobe resections. One hundred four (67%) children were seizure free (Engel class I), and 52 (33%) were not seizure free (Engel classes II-IV) at follow-up (mean follow-up interval, 2.3 years).
  
  
  RESULTS
  Seizure-free children recalled 19.3% more Wada memory items after ipsilateral injection than did non-seizure-free children (p = 0.008). If analysis was restricted to youngsters with temporal lobectomies (TLs), seizure-free children recalled 27.7% more items after ipsilateral injection than did non-seizure-free TL children (p = 0.004). With regard to individual patient prediction, 75% of children who had memory score asymmetries consistent with the seizure focus were seizure free. In contrast, only 56% of children whose memory score asymmetries were inconsistent with the seizure focus were seizure free (p = 0.01).
  
  
  CONCLUSIONS
  Results suggest that Wada memory performance asymmetries are related to the degree of seizure relief after epilepsy surgery in children and adolescents.
authors.affiliation: Medical College of Georgia, Augusta, Georgia 30912, U.S.A. glee@mail.mcg.edu
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Lee
authors.forename: Yong D
authors.initials: YD
authors.lastname: Park
authors.forename: Michael
authors.initials: M
authors.lastname: Westerveld
authors.forename: Ann
authors.initials: A
authors.lastname: Hempel
authors.forename: Lynn B
authors.initials: LB
authors.lastname: Blackburn
authors.forename: David W
authors.initials: DW
authors.lastname: Loring
mesh_terms: D000293:Adolescent; D000654:Amobarbital; D038481:Anterior Temporal Lobectomy; D002540:Cerebral Cortex / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004292:Dominance, Cerebral / Q000502:physiology*; D004828:Epilepsies, Partial / Q000503:physiopathology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D016896:Treatment Outcome; D014888:Wechsler Scales
chemical_list: D000654:Amobarbital