Complications during the Wada test.
OBJECTIVE
The intracarotid amobarbital procedure (IAP) is routinely used in the preoperative workup of patients with epilepsy. We previously reported dissections and seizures as complications of this procedure and now have reviewed our cohort for additional complications associated with the IAP.


METHODS
Charts of 677 consecutive patients were reviewed for complications during the IAP.


RESULTS
Complications were observed in 74 patients (10.9%) and included encephalopathy (7.2%), seizures (1.2%), strokes (0.6%), transient ischemic attacks (0.6%), localized hemorrhage at the catheter insertion site (0.6%), carotid artery dissections (0.4%), allergic reaction to contrast (0.3%), bleeding from the catheter insertion site (0.1%), and infection (0.1%). Older patients were more prone to strokes and dissections, whereas younger patients more frequently experienced seizures. Use of amobarbital was associated with encephalopathy, whereas methohexital was related to seizures.


CONCLUSIONS
The IAP bears the risk of minor and major complications in up to 11% of patients. Risks, benefits, and possible alternative options have to be considered when a patient is to undergo the IAP.
Loddenkemper
Tobias
T
Department of Neurology, Cleveland Clinic, Cleveland, OH, USA. tobias.loddenkemper@childrens.harvard.edu
Morris
Harold H
HH
Möddel
Gabriel
G
D000647:Amnesia / Q000209:etiology; D000654:Amobarbital / Q000009:adverse effects*; D001927:Brain Diseases / Q000145:classification / Q000209:etiology*; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology; D013997:Time Factors
D006993:Hypnotics and Sedatives; D000654:Amobarbital