Tolerability of propofol in Wada testing.

Area of Science:

• Neurology
• Epilepsy Research
• Neuroimaging

Background:

• Temporal lobe epilepsy (TLE) diagnosis often requires precise lateralization of cognitive functions.
• The Wada test is a crucial diagnostic tool for TLE, but its tolerability in diverse populations needs evaluation.

Purpose of the Study:

• To evaluate the safety and tolerability of propofol (PF) during the Wada test in an Arab patient cohort with TLE.
• To assess the efficacy of PF-assisted Wada testing for lateralizing language and memory dominance.

Main Methods:

• An observational study involving 9 Arab patients (mean age 26 years) with TLE undergoing the Wada test.
• Propofol (10 mg) was administered via the internal carotid artery (ICA) for hemispheric assessment.
• Electroencephalography (EEG) and neuropsychological tests were used to monitor effects and localize functions.

Main Results:

• Successful lateralization of speech dominance in 8 patients and memory dominance in 6 patients.
• Minor, transient complications included euphoria, ICA spasm, and facial/eye pain; no symptomatic blood pressure drops occurred.
• EEG showed characteristic delta slowing post-injection, confirming hemispheric effect.

Conclusions:

• Propofol (PF) is a well-tolerated anesthetic agent for Wada testing in Arab patients with TLE.
• The procedure demonstrated high efficacy in lateralizing cognitive functions, with a low incidence of significant adverse events.
• Close monitoring of blood pressure is recommended during propofol-assisted Wada testing.