Related Experiment Video
Updated: Jun 18, 2026
08:16
Infrared Thermography for the Detection of Changes in Brown Adipose Tissue Activity
Published on: September 28, 2022
Transient shivering during Wada test provides insight into human thermoregulation
Aashit K Shah1, Marie D Atkinson, Preeti Gupta
1Department of Neurology, Wayne State University, Detroit Medical Center, Detroit, Michigan 48201, USA. ashah@medwayne.edu
Epilepsia
|November 19, 2009
Summary
Transient shivering during the Wada test is common in epilepsy patients. This phenomenon may be linked to sodium amobarbital affecting the anterior hypothalamus and thermoregulation.
Area of Science:
- Neurology
- Neurophysiology
- Epilepsy Research
Background:
- Pharmacoresistant epilepsy often necessitates the Wada test for pre-surgical evaluation.
- Transient shivering is a recognized, though not fully understood, side effect of the Wada test.
Purpose of the Study:
- To identify clinical and radiographic predictors of shivering during the Wada test.
- To elucidate the underlying mechanisms of post-Wada test shivering.
Main Methods:
- Systematic review of prospectively collected patient data undergoing the Wada test.
- Analysis of demographic, clinical, and radiographic variables.
- Statistical analysis to determine shivering predictors.
Main Results:
- Shivering occurred in 46% of 59 patients (120 injections).
- No significant association found with age, gender, epilepsy characteristics, MRI findings, or EEG activity.
- Shivering was more frequent when posterior circulation was not visualized on cerebral angiogram post-injection.
Conclusions:
- Transient shivering during the Wada test is a common occurrence.
- A potential mechanism involves sodium amobarbital-induced functional lesion in the anterior hypothalamus.
- This may disinhibit posterior hypothalamic and brainstem thermoregulatory centers, causing shivering.
Related Concept Videos
01:19Assessing Body Temperature - Temporal Artery
Here is a stepwise guide to assessing the body temperature at the temporal artery using a temporal artery thermometer
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
01:14Assessing Body Temperature - Axilla
Procedural Guide for Assessing Axillary Body Temperature using a Digital Thermometer:
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
01:27Assessing Body Temperature - Rectal
Rectal temperature measurement is considered the most precise method for assessing core body temperature and typically registers higher than oral temperature. For adults, the rectal thermometer should be inserted 1 to 1.5 inches into the rectum to obtain the most accurate reading.
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
01:26Thermoregulation
The human body has a sophisticated thermoregulation system that employs negative feedback mechanisms to maintain an optimal core temperature. When the core temperature drops, peripheral and central thermoreceptors send signals to the hypothalamus, activating the heat-promoting center. This center triggers several responses aimed at increasing the core temperature. First, vasoconstriction reduces the flow of warm blood from internal organs to the skin so that the heat is not lost from the skin,...
01:25Body Temperature
The body's temperature, measured in degrees, is determined by the balance between heat production and dissipation to the surrounding environment. For instance, if exercising vigorously, the body will produce more heat, causing sweat and dissipating that heat. Despite extreme environmental conditions and physical exertion, the human temperature-control system maintains a constant core body temperature (the temperature of deep tissues, which are the tissues located beneath the skin and other...
01:07Body Temperature
Body temperature reflects the equilibrium between heat production and heat loss within the body. Most heat is generated by metabolically active tissues, particularly the liver, heart, brain, kidneys, and endocrine organs. At rest, skeletal muscles contribute 20–30% of total heat production, but during vigorous exercise, this can increase up to 30–40 times.
The average body temperature is approximately 37°C (98.6°F) and typically ranges from 36.1–37.2°C (97–99°F), remaining relatively stable...
The average body temperature is approximately 37°C (98.6°F) and typically ranges from 36.1–37.2°C (97–99°F), remaining relatively stable...