[Can functional MRI replace the Wada test?]

Temporal lobe epilepsy (TLE) is usually associated with specific impairment of memory functions. A reliable assessment of memory function is therefore a crucial element of the presurgical evaluation for epilepsy surgery, especially for temporal lobectomy. To date, intracarotid amobarbital testing remains the gold standard in evaluating memory before planning surgery in patients with refractory TLE, when neuropsychological testing is not contributive. Functional MRI holds great promise as a powerful tool in memory evaluation. Preliminary studies in epileptic patients have shown promising results. In the future, functional MRI will certainly contribute to partially replacing the Wada test or to evaluating the hippocampal memory capacities independently.