Does memory assessment during amobarbital testing predict postsurgical amnesia?

The intracarotid amobarbital procedure (Wada test) is an integral part of the preoperative evaluation for epilepsy surgery. Originally employed to identify patients with atypically cerebral language representation, it has evolved into a technique designed to also assess the capacity of a single temporal lobe to sustain recent memory function. Despite its importance in patient evaluation, this procedure remains unstandardized and varies among surgery centers. Thus, conclusions regarding the risk of a postsurgical amnestic syndrome can differ based solely on amobarbital procedural variations. We examine the theoretical assumptions associated with the memory component of intracarotid amobarbital assessment, review the available validity and reliability studies, and highlight the behavioral and methodologic limitations inherent in clinical reports of this technique.