Bilateral Wada test: amobarbital or propofol?

Seizure. 2014 Feb;23(2):122-8. doi: 10.1016/j.seizure.2013.10.009. Epub 2013 Oct 26.

Abstract

Purpose: The Wada test is still the gold standard procedure to predict language and memory deficits before temporal lobe epilepsy surgery. As amobarbital was no longer available, our aim was to validate propofol as an alternative.

Method: We retrospectively studied 47 patients who underwent a bilateral intracarotid procedure, performed with amobarbital (18), or propofol (29), between 2000 and 2010 during the preoperative evaluation of temporal lobe epilepsy.

Results: The number of patients experiencing an adverse event (mostly transient disturbance of consciousness or benign ocular symptoms) during both injections did not differ significantly between amobarbital and propofol. Hemispheric dominance was successfully determined in 96.5% patients with propofol vs. 94.4% with amobarbital for language, and in 72.4% under propofol vs. 77.7% under amobarbital for memory with no significant difference between groups.

Conclusion: Propofol can be used for the Wada test with an efficacy and safety comparable to amobarbital.

Keywords: Amobarbital; Memory; Propofol; Temporal epilepsy; Wada.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Amobarbital* / adverse effects
  • Anesthetics* / adverse effects
  • Brain / drug effects
  • Brain / physiopathology
  • Consciousness / drug effects
  • Epilepsy, Temporal Lobe / physiopathology*
  • Epilepsy, Temporal Lobe / surgery*
  • Female
  • Functional Laterality
  • Humans
  • Language
  • Male
  • Memory / drug effects
  • Memory / physiology
  • Middle Aged
  • Neuropsychological Tests*
  • Preoperative Care / adverse effects
  • Preoperative Care / methods
  • Propofol* / adverse effects
  • Retrospective Studies
  • Visual Perception / drug effects
  • Young Adult

Substances

  • Anesthetics
  • Amobarbital
  • Propofol