title: Behavioral measures and EEG monitoring using the Brain Symmetry Index during the Wada test in children.
abstract: EEG monitoring is used routinely during the Wada test in children. We quantified EEG asymmetry using the Brain Symmetry Index (BSI) to reduce subjectivity of EEG interpretation. Clinical and procedural variables were obtained and EEG data were retrieved from 46 patients with a total of 89 injections. The BSI, the absolute value of the relative difference of the average spectral density of the right and left hemisphere, was calculated over time for all EEGs. Lateralized slowing was correctly identified in all procedures. Asymmetry was minimal at baseline (BSI 0.16) and increased with injection of amobarbital (BSI 0.49). Various patterns of the BSI were seen in distinct clinical and procedural scenarios. In this retrospective analysis, the BSI could not predict an unsuccessful Wada procedure. Our results suggest application of the BSI during the Wada test in children is feasible. Real-time calculation of the BSI during EEG monitoring in the angiography suite is warranted for further validation.
authors.affiliation: Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital Boston, Boston, MA 02115, USA. jurriaan.peters@childrens.harvard.edu
authors.forename: Jurriaan M
authors.initials: JM
authors.lastname: Peters
authors.forename: Meritxell
authors.initials: M
authors.lastname: Tomas-Fernandez
authors.forename: Michel J A M
authors.initials: MJ
authors.lastname: van Putten
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
mesh_terms: D000293:Adolescent; D000654:Amobarbital / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008991:Monitoring, Physiologic; D009483:Neuropsychological Tests; D019990:Perioperative Care; D012189:Retrospective Studies; D013060:Speech / Q000187:drug effects; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D000654:Amobarbital