Methohexital - Induced lateralized periodic discharges during Wada test
Omar A Danoun1,2, Nicholas Beimer3, Henry Buchtel4
1Comprehensive Epilepsy Program, Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Clinical Neurophysiology Practice
|August 19, 2021
Summary
Methohexital can activate lateralized periodic discharges (LPDs) during Wada testing in epilepsy patients, potentially impacting memory performance. Continuous EEG monitoring is crucial for accurate Wada test interpretation.
Area of Science:
- Neurology
- Epileptology
- Neurophysiology
Background:
- The Wada test assesses cerebral hemisphere function for language and memory.
- Methohexital is used to induce discharges during intraoperative corticography.
Purpose of the Study:
- To investigate the frequency of methohexital-induced lateralized periodic discharges (LPDs) during Wada testing.
- To determine the clinical significance of these induced discharges.
Main Methods:
- Retrospective review of 174 adult patients undergoing Wada testing.
- Analysis of EEG data for methohexital-induced LPDs in epilepsy and brain tumor patients.
Main Results:
- Four epilepsy patients (2.29%) developed methohexital-induced LPDs ipsilateral to the injection hemisphere.
- LPDs were not observed in brain tumor patients.
- In one case, LPDs during memory testing correlated with impaired performance.
Conclusions:
- Methohexital can induce LPDs in the ipsilateral hemisphere during Wada testing.
- These induced discharges may affect memory assessment.
- Concurrent EEG monitoring is essential for accurate Wada test interpretation.
