The Wada Test-60th Year Anniversary Update-In Epilepsy Surgery

2012 ◽  
Keyword(s):  
Epilepsy Surgery ◽  
Wada Test

scholarly journals Bizarre behavior during intracarotid sodium amytal testing (Wada test): are they predictable?

2004 ◽  
Vol 62 (2b) ◽  
pp. 444-448 ◽  
Author(s):  
Luciano de Paola ◽  
Maria Joana Mäder ◽  
Francisco M.B. Germiniani ◽  
Patrícia Coral ◽  
Jorge A.A. Zavala ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Behavioral Modification ◽  
Wada Test ◽  
Language Lateralization ◽  
Inaccurate Data ◽  
Hemisphere Dominance ◽  
Hemispheric Functioning ◽  
Bizarre Behavior ◽  
Overall Reactions

The intracarotid sodium amytal test (ISAT or Wada Test) is a commonly performed procedure in the evaluation of patients with clinically refractory epilepsy candidates to epilepsy surgery. Its goal is to promote selective and temporary interruption of hemispheric functioning, seeking to define language lateralization and risk for memory compromise following surgery. Behavioral modification is expected during the procedure. Even though it may last several minutes, in most cases it is subtle and easily manageable. We report a series of patients in whom those reactions were unusually bizarre, including agitation and aggression. Apart of the obvious technical difficulties (patients required physical restraining) those behaviors potentially promote testing delay or abortion and more importantly, inaccurate data. We reviewed those cases, seeking for features that might have predicted their occurrence. Overall, reactions are rare, seen in less than 5% of the ISAT procedures. The barbiturate effect, patients' psychiatric profiles, hemisphere dominance or selectiveness of the injection were not validated as predictors. Thorough explanation, repetition and simulation may be of help in lessening the risk of those reactions.

Does the Wada Test Predict Memory Decline following Epilepsy Surgery?

2002 ◽  
Vol 3 (1) ◽  
pp. 4-15 ◽  
Author(s):  
Roy C. Martin ◽  
Christopher L. Grote
Keyword(s):  
Epilepsy Surgery ◽  
Wada Test ◽  
Memory Decline

Can the Wada test predict seizure outcome in epilepsy surgery patients

2007 ◽  
Vol 68 (2) ◽  
pp. 202
Author(s):  
D. Van Roost ◽  
P. Boon ◽  
G. Vingerhoets
Keyword(s):  
Epilepsy Surgery ◽  
Seizure Outcome ◽  
Wada Test

FV 4. Contribution of Wada test results to the prediction of change in verbal learning and memory function after epilepsy surgery in the temporal lobe

2021 ◽  
Vol 132 (8) ◽  
pp. e30-e31
Author(s):  
N. Conradi ◽  
F. Rosenberg ◽  
S. Knake ◽  
L. Biermann ◽  
A. Haag ◽  
...  
Keyword(s):  
Learning And Memory ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Memory Function ◽  
Verbal Learning ◽  
Test Results ◽  
Wada Test

028 Feasibility of the Wada test in paediatric candidates for epilepsy surgery

1999 ◽  
Vol 3 (6) ◽  
pp. A34
Author(s):  
F.E. Jansen ◽  
C.W.M. Van Veelen ◽  
P.C. Van Rijen ◽  
A.C. Van Huffelen ◽  
W.C.J. Alpherts ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Wada Test

scholarly journals Language hemispheric dominance analyzed with magnetic resonance DTI: correlation with the Wada test

2020 ◽  
pp. 1-8
Author(s):  
Juan Delgado-Fernández ◽  
Maria Ángeles García-Pallero ◽  
Rafael Manzanares-Soler ◽  
Pilar Martín-Plasencia ◽  
Guillermo Blasco ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Diffusion Tensor ◽  
Hemispheric Dominance ◽  
Uncinate Fasciculus ◽  
Arcuate Fasciculus ◽  
Dominant Hemisphere ◽  
Wada Test ◽  
Pharmacoresistant Epilepsy ◽  
Linear Discriminant ◽  
Dominance Testing

OBJECTIVELanguage lateralization is a major concern in some patients with pharmacoresistant epilepsy who will face surgery; in these patients, hemispheric dominance testing is essential to avoid further complications. The Wada test is considered the gold standard examination for language localization, but is invasive and requires many human and material resources. Functional MRI and tractography with diffusion tensor imaging (DTI) have demonstrated that they could be useful for locating language in epilepsy surgery, but there is no evidence of the correlation between the Wada test and DTI MRI in language dominance.METHODSThe authors performed a retrospective review of patients who underwent a Wada test before epilepsy surgery at their institution from 2012 to 2017. The authors retrospectively analyzed fractional anisotropy (FA), number and length of fibers, and volume of the arcuate fasciculus and uncinate fasciculus, comparing dominant and nondominant hemispheres.RESULTSTen patients with temporal lobe epilepsy were reviewed. Statistical analysis showed that the mean FA of the arcuate fasciculus in the dominant hemisphere was higher than in the nondominant hemisphere (0.369 vs 0.329, p = 0.049). Also, the number of fibers in the arcuate fasciculus was greater in the dominant hemisphere (881.5 vs 305.4, p = 0.003). However, no differences were found in the FA of the uncinate fasciculus or number of fibers between hemispheres. The length of fibers of the uncinate fasciculus was longer in the dominant side (74.4 vs 50.1 mm, p = 0.05). Volume in both bundles was more prominent in the dominant hemisphere (12.12 vs 6.48 cm3, p = 0.004, in the arcuate fasciculus, and 8.41 vs 4.16 cm3, p = 0.018, in the uncinate fasciculus). Finally, these parameters were compared in patients in whom the seizure focus was situated in the dominant hemisphere: FA (0.37 vs 0.30, p = 0.05), number of fibers (114.4 vs 315.6, p = 0.014), and volume (12.58 vs 5.88 cm3, p = 0.035) in the arcuate fasciculus were found to be statistically significantly higher in the dominant hemispheres. Linear discriminant analysis of FA, number of fibers, and volume of the arcuate fasciculus showed a correct discrimination in 80% of patients (p = 0.024).CONCLUSIONSThe analysis of the arcuate fasciculus and other tract bundles by DTI could be a useful tool for language location testing in the preoperative study of patients with refractory epilepsy.

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