Bilateral Wada test: amobarbital or propofol?

PURPOSE: The Wada test is still the gold standard procedure to predict language and memory deficits before temporal lobe epilepsy surgery. As amobarbital was no longer available, our aim was to validate propofol as an alternative.

METHOD: We retrospectively studied 47 patients who underwent a bilateral intracarotid procedure, performed with amobarbital (18), or propofol (29), between 2000 and 2010 during the preoperative evaluation of temporal lobe epilepsy.

RESULTS

The number of patients experiencing an adverse event (mostly transient disturbance of consciousness or benign ocular symptoms) during both injections did not differ significantly between amobarbital and propofol. Hemispheric dominance was successfully determined in 96.5% patients with propofol vs. 94.4% with amobarbital for language, and in 72.4% under propofol vs. 77.7% under amobarbital for memory with no significant difference between groups.

CONCLUSION

Propofol can be used for the Wada test with an efficacy and safety comparable to amobarbital.