Aktuelle Neurologie 2007; 34 - P479
DOI: 10.1055/s-2007-987750

The Wada-Test in 2000–2005at German, Swiss and Austrian and Dutch Epilepsy-Centres – the experience of the Arbeitsgemeinschaft für prächirurgische Epilepsiediagnostik und operative Epilepsietherapie e.V regarding 1421 procedures

A Haag 1, S Knake 1, HM Hamer 1, F Boesebeck 1, H Freitag 1, R Schulz 1, P Baum 1, C Helmstaedter 1, J Wellmer 1, H Urbach 1, P Hopp 1, T Mayer 1, A Hufnagel 1, H Jokeit 1, H Lerche 1, I Uttner 1, HJ Meencke 1, H Meierkord 1, E Pauli 1, U Runge 1, J Saar 1, E Trinka 1, T Benke 1, S Vulliemoz 1, G Wiegand 1, U Stephani 1, HG Wieser 1, D Rating 1, K Werhahn 1, S Noachtar 1, A Schulze-Bonhage 1, K Wagner 1, W Alpherts 1, W van Emde Boas 1, F Rosenow 1
  • 1Marburg, Münster, Bethel, Leipzig, Bonn, Radeberg, Essen; Zürich, CH; Ulm, Berlin, Erlangen, Greifswald, Kehl-Kork; Innsbruck, A; Genf, CH; Kiel; Heidelberg, Mainz, München, Freiburg; Heemstede, NL

For the Arbeitsgemeinschaft für prächirurgische Epilepsiediagnostik und operative Epilepsietherapie e.V we asked 26 German, Swiss, Austrian and Dutch Epilepsy-Centres to report the use of the Wada-Test (intracarotid amobarbital procedure; IAP) from 2000 to 2005. We used a half-standardized questionnaire to ask about clinical indications for the procedure, number of tests applied, the test-protocol, interpretation of results and complication rates. We also asked representatives to give their opinion regarding the current and future role of the Wada-Test in presurgical diagnosis of epilepsy (e.g. reliability, validity, alternative methods).

16 of 23 centres providing information stated to have applied the Wada-Test during the requested time period. Altogether 1421 Wada-Tests had been carried out, with the classic bilateral IAP having the highest proportion (73%). The overall complication rate was 1.09% (0.36% with permanent deficit). Test protocols reported were similar regarding the procedure itself as well as language and memory testing, even though no universal standard protocol exists. Clinicians rated the Wada-Test to have good reliability and validity for language determination, whereas the reliability and validity for memory lateralization was questioned. As expected, functional MRI was the most frequently used non-invasive imaging technique. More than 50% of the centers use it as a standard procedure for language lateralization and approximately 30% do apply it regularly for memory lateralization. Other non-invasive functional imaging techniques used less frequently were functional transcranial Dopplersonography (fTCD) or the dichotic listening test as well as repetitive transcranial magnetic stimulation (rTMS), near infrared spectroscopy (NIRS), event-related potentials (N400/N300) and PET. Sixty seven percent of representatives believe that the Wada-Test will be replaced by other imaging techniques and nearly all representatives agreed with the statement, that Wada-Test frequency will decrease in the future.