Wada memory performance predicts seizure outcome after epilepsy surgery in children

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

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: Wada memory asymmetries were examined in children from four comprehensive epilepsy surgery centers who subsequently underwent epilepsy surgery to determine whether Wada memory performance could predict degree of seizure relief in children. Methods: One hundred fifty-six children (between ages 5 and 16 years) with intractable epilepsy underwent Wada testing before resective epilepsy surgery (93 within the left hemisphere, and 63 within the right hemisphere). Memory stimuli were presented soon after intracarotid amobarbital injection, and recognition memory for the items was assessed after return to neurologic baseline. Eighty-eight children underwent unilateral temporal lobe resection, and 68 had extratemporal lobe resections. One hundred four (67%) children were seizure free (Engel class 1), and 52 (33%) were not seizure free (Engel classes II-IV) at follow-up (mean follow-up interval, 2.3 years). Results: Seizure-free children recalled 19.3% more Wada memory items after ipsilateral injection than did non-seizure-free children (p = 0.008). If analysis was restricted to youngsters with temporal lobectomies (TLs), seizure-free children recalled 27.7% more items after ipsilateral injection than did non-seizure-free TL children (p = 0.004). With regard to individual patient prediction, 75% of children who had memory score asymmetries consistent with the seizure focus were seizure free. In contrast, only 56% of children whose memory score asymmetries were inconsistent with the seizure focus were seizure free (p = 0.01). Conclusions: Results suggest that Wada memory performance asymmetries are related to the degree of seizure relief after epilepsy surgery in children and adolescents.

Original languageEnglish (US)
Pages (from-to)936-943
Number of pages8
JournalEpilepsia
Volume44
Issue number7
DOIs
StatePublished - Jul 1 2003

Fingerprint

Epilepsy
Seizures
Injections
Amobarbital
Temporal Lobe
Nervous System

Keywords

  • Childhood epilepsy
  • Epilepsy surgery
  • Intracarotid amobarbital procedure
  • Memory
  • Temporal lobectomy
  • Wada testing

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Lee, G. P., Park, Y. D., Westerveld, M., Hempel, A., Blackburn, L. B., & Loring, D. W. (2003). Wada memory performance predicts seizure outcome after epilepsy surgery in children. Epilepsia, 44(7), 936-943. https://doi.org/10.1046/j.1528-1157.2003.05003.x

Wada memory performance predicts seizure outcome after epilepsy surgery in children. / Lee, Gregory P; Park, Yong D; Westerveld, Michael; Hempel, Ann; Blackburn, Lynn B.; Loring, David W.

In: Epilepsia, Vol. 44, No. 7, 01.07.2003, p. 936-943.

Research output: Contribution to journalArticle

Lee, GP, Park, YD, Westerveld, M, Hempel, A, Blackburn, LB & Loring, DW 2003, 'Wada memory performance predicts seizure outcome after epilepsy surgery in children', Epilepsia, vol. 44, no. 7, pp. 936-943. https://doi.org/10.1046/j.1528-1157.2003.05003.x
Lee, Gregory P ; Park, Yong D ; Westerveld, Michael ; Hempel, Ann ; Blackburn, Lynn B. ; Loring, David W. / Wada memory performance predicts seizure outcome after epilepsy surgery in children. In: Epilepsia. 2003 ; Vol. 44, No. 7. pp. 936-943.
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AU - Loring, David W.

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N2 - Purpose: Wada memory asymmetries were examined in children from four comprehensive epilepsy surgery centers who subsequently underwent epilepsy surgery to determine whether Wada memory performance could predict degree of seizure relief in children. Methods: One hundred fifty-six children (between ages 5 and 16 years) with intractable epilepsy underwent Wada testing before resective epilepsy surgery (93 within the left hemisphere, and 63 within the right hemisphere). Memory stimuli were presented soon after intracarotid amobarbital injection, and recognition memory for the items was assessed after return to neurologic baseline. Eighty-eight children underwent unilateral temporal lobe resection, and 68 had extratemporal lobe resections. One hundred four (67%) children were seizure free (Engel class 1), and 52 (33%) were not seizure free (Engel classes II-IV) at follow-up (mean follow-up interval, 2.3 years). Results: Seizure-free children recalled 19.3% more Wada memory items after ipsilateral injection than did non-seizure-free children (p = 0.008). If analysis was restricted to youngsters with temporal lobectomies (TLs), seizure-free children recalled 27.7% more items after ipsilateral injection than did non-seizure-free TL children (p = 0.004). With regard to individual patient prediction, 75% of children who had memory score asymmetries consistent with the seizure focus were seizure free. In contrast, only 56% of children whose memory score asymmetries were inconsistent with the seizure focus were seizure free (p = 0.01). Conclusions: Results suggest that Wada memory performance asymmetries are related to the degree of seizure relief after epilepsy surgery in children and adolescents.

AB - Purpose: Wada memory asymmetries were examined in children from four comprehensive epilepsy surgery centers who subsequently underwent epilepsy surgery to determine whether Wada memory performance could predict degree of seizure relief in children. Methods: One hundred fifty-six children (between ages 5 and 16 years) with intractable epilepsy underwent Wada testing before resective epilepsy surgery (93 within the left hemisphere, and 63 within the right hemisphere). Memory stimuli were presented soon after intracarotid amobarbital injection, and recognition memory for the items was assessed after return to neurologic baseline. Eighty-eight children underwent unilateral temporal lobe resection, and 68 had extratemporal lobe resections. One hundred four (67%) children were seizure free (Engel class 1), and 52 (33%) were not seizure free (Engel classes II-IV) at follow-up (mean follow-up interval, 2.3 years). Results: Seizure-free children recalled 19.3% more Wada memory items after ipsilateral injection than did non-seizure-free children (p = 0.008). If analysis was restricted to youngsters with temporal lobectomies (TLs), seizure-free children recalled 27.7% more items after ipsilateral injection than did non-seizure-free TL children (p = 0.004). With regard to individual patient prediction, 75% of children who had memory score asymmetries consistent with the seizure focus were seizure free. In contrast, only 56% of children whose memory score asymmetries were inconsistent with the seizure focus were seizure free (p = 0.01). Conclusions: Results suggest that Wada memory performance asymmetries are related to the degree of seizure relief after epilepsy surgery in children and adolescents.

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