The intracarotid sodium amobarbital (ISA) procedure is effective in determining cerebral language dominance. However, severe emotional and behavioral reactions during ISA evaluation may invalidate the results or necessitate aborting the procedure. In an effort to identify patients at risk for behavioral complications, we reviewed 92 patients undergoing ISA evaluation and found five with severe changes in dect and behavior following amobarbital injection, ranging from prolonged coma to an extended confusional state. Severe behavioral disturbances were more likely to occur in patienta with left frontal structural lesions upon injecting amobarbital into the right hemisphere. Analysis of patients with structural lesions of the anterior regions of the right hemisphere showed no evidence of similar behavioral complications. Thew findings suggest a special role for the left frontal region in the inhibition of affective expression and provide further evidence of the importance of right hemisphere mechanisms in emotion.
ASJC Scopus subject areas
- Clinical Neurology