Prediction of seizure-onset laterality by using Wada memory asymmetries in pediatric epilepsy surgery candidates.

Full Abstract

PURPOSE:
Because the capacity of intracarotid amobarbital (Wada) memory assessment to predict seizure-onset laterality in children has not been thoroughly investigated, three comprehensive epilepsy surgery centers pooled their data and examined Wada memory asymmetries to predict side of seizure onset in children being considered for epilepsy surgery.

METHODS:
One hundred fifty-two children with intractable epilepsy underwent Wada testing. Although the type and number of memory stimuli and methods varied at each institution, all children were presented with six to 10 items soon after amobarbital injection. After return to neurologic baseline, recognition memory for the stimuli was assessed. Seizure onset was determined by simultaneous video-EEG recordings of multiple seizures.

RESULTS:
In children with unilateral temporal lobe seizures (n = 87), Wada memory asymmetries accurately predicted seizure laterality to a statistically significant degree. Wada memory asymmetries also correctly predicted side of seizure onset in children with extra-temporal lobe seizures (n = 65). Although individual patient prediction accuracy was statistically significant in temporal lobe cases, onset laterality was incorrectly predicted in < or =52% of children with left temporal lobe seizure onset, depending on the methods and asymmetry criterion used. There also were significant differences between Wada prediction accuracy across the three epilepsy centers.

CONCLUSIONS:
Results suggest that Wada memory assessment is useful in predicting side of seizure onset in many children. However, Wada memory asymmetries should be interpreted more cautiously in children than in adults.

Learn Faster Today Improve your study skills

Author information

Author/s: Lee, Gregory P (GP); Park, Yong D (YD); Hempel, Ann (A); Westerveld, Michael (M); Loring, David W (DW);

Affiliation: Departments of Occupational Therapy and Neurology, Medical College of Georgia, Augusta, Georgia 30912-0700, USA. glee(-atsign-)mail.mcg.edu

Journal and publication information

Publication Type: Journal Article; Multicenter Study

Journal: Epilepsia (Epilepsia), published in United States. (Language: eng)

Reference: 2002-Sep; vol 43 (issue 9) : pp 1049-55

Dates: Created 2002/08/29; Completed 2002/10/07; Revised 2006/11/15;

PMID: 12199730, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Age Factors
Amobarbital - diagnostic use; pharmacology
Brain - drug effects; physiopathology; surgery
Carotid Artery, Internal
Child
Electroencephalography - statistics & numerical data
Epilepsy - diagnosis; physiopathology; surgery
Female

Functional Laterality - drug effects; physiology
Humans
Language
Male
Memory - drug effects; physiology
Neuropsychological Tests
Predictive Value of Tests
Probability
Videotape Recording

Associated Chemicals: Amobarbital (57-43-2)

These are the highest related articles currently in the database:

See 100+ related articles.