The intracarotid amobarbital sodium (Amytal) procedure (IAP) was performed for 46 patients with temporal lobe epilepsy (21 with left seizure foci; 25 with right seizure foci). After anteromedial temporal lobectomy, neuronal densities were established for hippocampal subfields CA1, CA2, and CA3; the hilum; and the dentate granule cell layer. Intracarotid amobarbital procedure memory results were related to CA3 neuronal loss only. Patients who did not demonstrate memory after injection contralateral to the seizure focus had significantly fewer cells in CA3 than patients who did. Additionally, a significant correlation was observed between the intracarotid amobarbital procedure memory examination raw score after injection contralateral to the seizure focus and CA3 cell density. Using chi 2 analysis, significant differences were documented in the frequency with which memory was demonstrated after injection contralateral to the seizure focus for groups of patients classified by degree of CA3 neuronal loss. This finding supports prior research showing subfield specificity in some memory processes.

Download full-text PDF

Source
http://dx.doi.org/10.1001/archneur.1991.00530130056020DOI Listing

Publication Analysis

Top Keywords

intracarotid amobarbital
16
amobarbital procedure
12
injection contralateral
12
contralateral seizure
12
seizure focus
12
seizure foci
8
procedure memory
8
ca3 neuronal
8
neuronal loss
8
memory
6

Similar Publications

As speech-related symptoms of Landau-Kleffner syndrome (LKS) are often refractory to pharmacotherapy, and resective surgery is rarely available due to the involvement of the vital cortex, multiple subpial transection (MST) was suggested to improve patient outcome and preserve cortical functions. Here, we analyze the reports about MST use in LKS, regarding its impact on seizures, language, behavior, EEG, cognition, and reported adverse effects. In conditions like LKS, surgery is not a popular treatment option and presumably should be considered sooner.

View Article and Find Full Text PDF

Discordant Wada and fMRI language lateralization: a case report.

J Int Med Res

September 2024

Key Laboratory of Brain Functional Genomics (MOE and Shanghai), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.

Functional MRI (fMRI) is gaining importance in the preoperative assessment of language for presurgical planning. However, inconsistencies with the Wada test might arise. This current case report describes a very rare case of an epileptic patient who exhibited bilateral distribution (right > left) in the inferior frontal gyrus (laterality index [LI] = -0.

View Article and Find Full Text PDF

Determination of language hemispheric dominance (HD) in patients undergoing evaluation for epilepsy surgery has traditionally relied on the sodium amobarbital (Wada) test. The emergence of non-invasive methods for determining language laterality has increasingly shown to be a viable alternative. In this study, we assessed the efficacy of transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG), compared to the Wada test, in determining language HD in a sample of 12 patients.

View Article and Find Full Text PDF

The conventional intracarotid amobarbital (Wada) test has been used to assess memory function in patients being considered for temporal lobe epilepsy (TLE) surgery. Minimally invasive approaches that target the medial temporal lobe (MTL) and spare neocortex are increasingly used, but a knowledge gap remains in how to assess memory and language risk from these procedures. We retrospectively compared results of two versions of the Wada test, the intracarotid artery (ICA-Wada) and posterior cerebral artery (PCA-Wada) approaches, with respect to predicting subsequent memory and language outcomes, particularly after stereotactic laser amygdalohippocampotomy (SLAH).

View Article and Find Full Text PDF

Assessment of language lateralization in epilepsy patients using the super-selective Wada test.

Acta Neurochir (Wien)

February 2024

Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan.

Article Synopsis
  • - The study evaluates the super-selective Wada test (ssWada) as a safer and more effective alternative to the classical Wada test (cWada) for assessing language dominance in patients with epilepsy, as cWada has significant adverse effects in 10-30% of cases.
  • - Data from 17 patients revealed that ssWada identified language dominance accurately, showing 12 left, 3 right, and 2 bilateral cases, while adverse effects were much lower than those seen with cWada.
  • - The ssWada demonstrated a high accuracy rate of over 90% in determining language dominance with minimal side effects, making it a promising tool for assessing patients’ language facilities.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!