Maculo-papillary branch retinal artery occlusions following the Wada test

Language lateralization using MEG beta frequency desynchronization during auditory oddball stimulation with one-syllable words

Some patients with epilepsy have difficulty performing complex language tasks due to the long duration of the disease and cognitive side effects of antiepileptic drugs. Therefore, a simple passive paradigm would be useful for determining the language dominance lateralization in epilepsy patients. The goal of this study was to develop an efficient and non-invasive analysis method for determining language dominance in epilepsy patients. To this end, magnetoencephalography was performed while an auditory stimulus sequence comprised of two one-syllable spoken words was presented to 17 subjects in an oddball paradigm without subject response. The time-frequency difference between deviant and standard sounds was then analyzed in the source space using a spatial filtering method that was based on minimum-norm estimation. The laterality index was estimated in language-related regions of interest (ROI). The results were compared to the traditional lateralization method using the Wada test. Beta band oscillation activity decreased during deviant stimulation, and the lateralization of the decrease was in good agreement with the Wada test, in the posterior part of the inferior frontal gyrus in 94% of the subjects and in the posterior part of the superior temporal gyrus in 71% of the subjects. In conclusion, the ROI-based time-frequency difference between deviant and standard sounds can be used to assess language lateralization in accordance with the Wada test.

Endovascular ablation of a temporal lobe epileptogenic focus - a complication of Wada testing

The authors report on a patient with a long history of medically refractory temporal lobe epilepsy. During pre-operative evaluation for anterior temporal lobectomy he underwent a Wada test for speech and memory lateralization. During the procedure, he suffered a focal cerebral infarct, within the right medial temporal lobe, at the site of the epileptic focus. This resulted in the resolution of his seizure disorder. The possibility of endovascular management of seizure disorders of the temporal lobe should be investigated further as a potentially minimal invasive therapeutic option for medically intractable epilepsy.