gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Reliability of Wada test for predicting verbal memory outcome after anterior temporal lobectomy in patients with mesial temporal lobe epilepsy

Meeting Abstract

  • M. Katagiri - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • K. Iida - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • K. Kagawa - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • Y. Kiura - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • A. Hashizume - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • T. Nishimoto - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
  • R. Hanaya - Department of Neurosurgery, Kagoshima University, Kagoshima, Japan
  • K. Arita - Department of Neurosurgery, Kagoshima University, Kagoshima, Japan
  • K. Kurisu - Department of Neurosurgery, Hiroshima University, Hiroshima, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 038

DOI: 10.3205/12dgnc425, URN: urn:nbn:de:0183-12dgnc4255

Published: June 4, 2012

© 2012 Katagiri et al.
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Outline

Text

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.