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

Gregory P. Lee, Yong D. Park, Ann Hempel, Michael Westerveld, David W. Loring

Research output: Contribution to journalArticle

13 Citations (Scopus)

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 ≤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.

Original languageEnglish (US)
Pages (from-to)1049-1055
Number of pages7
JournalEpilepsia
Volume43
Issue number9
DOIs
StatePublished - Sep 1 2002

Fingerprint

Epilepsy
Seizures
Pediatrics
Temporal Lobe
Amobarbital
Video Recording
Nervous System
Electroencephalography
Injections

Keywords

  • Children
  • Epilepsy surgery
  • Intracarotid amobarbital procedure
  • Lateralized cerebral asymmetry
  • Memory
  • Wada test

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Prediction of seizure-onset laterality by using Wada memory asymmetries in pediatric epilepsy surgery candidates. / Lee, Gregory P.; Park, Yong D.; Hempel, Ann; Westerveld, Michael; Loring, David W.

In: Epilepsia, Vol. 43, No. 9, 01.09.2002, p. 1049-1055.

Research output: Contribution to journalArticle

Lee, Gregory P. ; Park, Yong D. ; Hempel, Ann ; Westerveld, Michael ; Loring, David W. / Prediction of seizure-onset laterality by using Wada memory asymmetries in pediatric epilepsy surgery candidates. In: Epilepsia. 2002 ; Vol. 43, No. 9. pp. 1049-1055.
@article{cd955f7b6ae541259f1b22920db899cb,
title = "Prediction of seizure-onset laterality by using Wada memory asymmetries in pediatric epilepsy surgery candidates",
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 ≤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.",
keywords = "Children, Epilepsy surgery, Intracarotid amobarbital procedure, Lateralized cerebral asymmetry, Memory, Wada test",
author = "Lee, {Gregory P.} and Park, {Yong D.} and Ann Hempel and Michael Westerveld and Loring, {David W.}",
year = "2002",
month = "9",
day = "1",
doi = "10.1046/j.1528-1157.2002.48301.x",
language = "English (US)",
volume = "43",
pages = "1049--1055",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Prediction of seizure-onset laterality by using Wada memory asymmetries in pediatric epilepsy surgery candidates

AU - Lee, Gregory P.

AU - Park, Yong D.

AU - Hempel, Ann

AU - Westerveld, Michael

AU - Loring, David W.

PY - 2002/9/1

Y1 - 2002/9/1

N2 - 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 ≤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.

AB - 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 ≤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.

KW - Children

KW - Epilepsy surgery

KW - Intracarotid amobarbital procedure

KW - Lateralized cerebral asymmetry

KW - Memory

KW - Wada test

UR - http://www.scopus.com/inward/record.url?scp=0036712791&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036712791&partnerID=8YFLogxK

U2 - 10.1046/j.1528-1157.2002.48301.x

DO - 10.1046/j.1528-1157.2002.48301.x

M3 - Article

C2 - 12199730

AN - SCOPUS:0036712791

VL - 43

SP - 1049

EP - 1055

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 9

ER -