Amobarbital Effects and Lateralized Brain Function: The Wada by David W. Loring, Kimford J. Meador, Gregory P. Lee, Don W.

By David W. Loring, Kimford J. Meador, Gregory P. Lee, Don W. King

The intracarotid amobarbital (or Amytal) process is often often called the Wada try in tribute to Juhn Wada, the general practitioner who devised the approach and played the 1st uncomplicated animal learn and scientific experiences with this technique. Wada checking out has develop into an essential component of the pre­ operative review for epilepsy surgical procedure. apparently, in spite of the fact that, Wada firstly constructed this system as a strategy to evaluate language dominance in psychiatric sufferers so that electroconvulsant treatment may be utilized unilaterally to the non-dominant hemisphere. Epilepsy surgical procedure has matured as a manageable remedy for intractable seizures and is not any longer confmed to a couple significant universities and clinical institutes. but, as is more and more transparent by means of reading the surveys of techniques utilized by epilepsy surgical procedure facilities (e.g., Rausch, 1987; Snyder, Novelly, & Harris, 1990), there isn't in basic terms nice heterogeneity within the equipment used in the course of Wada checking out to evaluate language and reminiscence capabilities, yet there additionally looks a scarcity of consensus in regards to the theoretical assumptions, and maybe, even the pursuits of this procedure.

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Extra resources for Amobarbital Effects and Lateralized Brain Function: The Wada Test

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Amobarbital injection is used to model the effects of surgery on memory by creating temporary dysfunction of the temporal lobe and hippocampus while the patient is presented new material to remember. However, patients may fail Wada memory testing for reasons other than the ability of the contralateral temporal lobe to sustain memory, and methodologic limitations make the validation of this technique difficult. Consequently, performance on this test should not be considered absolute. The different options that may be pursued if a patient fails the Wada memory test are discussed.

Although poor object identification was interpreted as recognition difficulty, visual agnosia is not observed following temporal lobectomy. An upper quadrantanopsia was also present, indicating a larger resection than is now typical for language dominant hemisphere resections with increased likelihood of mild post-operative aphasia. Even if the difficulties described by Baldwin are attributed to memory, an amnestic syndrome cannot be inferred because the patient's memory improved over a 10-month period allowing his return to work.

The number of subjects studied was not identified. Silfvenius and colleagues (Silfvenius, Blom, Nilsson & Christianson, 1984; Silfvenius & Blom, 1984) examined Wada memory following injection of 150170 mg amobarbital in 18 patients. Patients included those with unilateral and bilateral temporal lobe seizures, and others with frontal lobe seizures. Prior to injection, patients were presented 4 types of material-- a color, a numeral, a simple sentence, and tactually presented common objects. Following disappearance of contralateral EEG slowing, typically 30-50 seconds postinjection, 6 words and 6 pictures were presented.

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