Neurobehavioral differences in superselective Wada testing with amobarbital versus lidocaine.

Four patients with cerebral arteriovenous malformations (AVMs) underwent superselective Wada testing with intraarterial amobarbital and lidocaine before embolization. In all four patients, the use of lidocaine detected clinically significant neurologic deficits that amobarbital alone did not, likely because of the pharmacodynamic differences of the two agents. The use of lidocaine with amobarbital for superselective Wada testing in patients with cerebral AVMs may improve the sensitivity and predictive value of this test in the future.