Artikel
Reliability of Wada test for predicting verbal memory outcome after anterior temporal lobectomy in patients with mesial temporal lobe epilepsy
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Verbal memory (VM) exacerbation is a major concern after anterior temporal lobectomy (ATL) of memory-dominant hemisphere in patients with mesial temporal lobe epilepsy (MTLE). We elucidated the reliability of the Wada test for predicting the VM outcome after ATL.
Methods: Thirty five patients (age range: 13–58, mean: 39.0 years) who were subjected to the Wada test for lateralizing verbal-memory dominancy (VMD). They were divided into 2 groups based on the Wechsler Memory Scale-revised (WMS-R) VM scores: >90 (A) and <90 (B). Lateralized VMD was defined as follows: word recognition scores of >6 and <3 (total: 9 tasks; 3 before and 6 after propofol injection) for lateralizing unilateral and contralateral hemispheres, with scores of >4 and <2 (total: 6 tasks after propofol injection) for the similar lateralizing procedures, respectively.
Results: In A and B, the Wada test predicted lateralized VMD in 4 of 16 (25%) and in 1 of 19 (5.3%) patients, respectively. Among 17 ATL-treated patients, 4 (3 in A) had lateralized VMD: 2 of these 4 patients suffered exacerbated VM (>10; lower than preoperative scores) after memory-dominant ATL, while the remaining 2 had preserved memory after memory-nondominant ATL. Of the remaining 13 patients, VM in 2 (A) of 6 language-dominant ATL and in 3 (2 in A) of 7 language-nondominant ATL cases exacerbated after surgery.
Conclusions: Patients who have well-preserved VM before surgery may show memory disturbance even after language-nondominant ATL. The Wada test may be useful for predicting VM outcome in lateralized VMD patients.