[The intracarotid amobarbital test. Neuroradiologic and neuropsychologic aspects]

In presurgical evaluation of epilepsy, unilateral cerebral inactivation by means of intracarotid injection of amobarbital is used for the determination of cerebral dominance for language and memory functions. This intracarotid amobarbital test (IAT) is intended to yield prognoses concerning postsurgical neuropsychological and neurological deficits. In the present review, neuroradiological and neuropsychological aspects of the procedure are discussed. Each IAT is preceded by a cerebral angiography to exclude or detect vascular anomalies that might be relevant to the interpretation of neuropsychological test data. The main methodological problems of the IAT are interference of various cognitive deficits and monitoring of the course of amobarbital action. Alternative procedures of determination of hemispheric asymmetries--positron emission tomography, electrical stimulation mapping, and noninvasive methods like tachistoscopy--mainly yield data complementary to the results of the IAT and hence are not taken as substitutes of that technique.