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[Preoperative diagnosis: the Wada test with SPECT control for localizing brain function in therapy-refractory
M Kurthen1, H J Biersack, D B Linke
1Abteilung für Klinische Neurophysiologie, Neurochirurgischen Universitätsklinik Bonn.
Neurochirurgia
|May 1, 1988
Summary
The Wada test, combined with SPECT imaging, helps assess cognitive function lateralization and hemisphere blockade. This aids in predicting postoperative deficits and clarifying surgical indications for refractory epilepsy.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Epilepsy surgery requires extensive diagnostics for treatment-refractory cases.
- Neuropsychological assessment is crucial for surgical indication clarification.
Observation:
- The Wada test induces temporary hemisphere anesthesia via sodium amytal injection.
- Simultaneous SPECT imaging with 99mTc-labeled HM-PAO visualizes hemisphere blockade extent and cerebral uptake.
- Neuropsychological testing evaluates the non-anesthetized hemisphere's performance.
Findings:
- Wada test reveals cognitive function lateralization (speech, memory).
- SPECT imaging quantifies hemisphere blockade and identifies diaschisis.
- Combined approach provides insights into functional brain organization and potential deficits.
Implications:
- Results guide the assessment of surgical indications in refractory epilepsy.
- Predicts potential postoperative cognitive deficits, informing surgical decisions.
- Facilitates a more differentiated approach to epilepsy surgery planning.