Functional MRI and the Wada test provide complementary information for predicting post-operative seizure control

William D.S. Killgore, Guila Glosser, Daniel J. Casasanto, Jacqueline A. French, David C. Alsop, John A. Detre

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

Prediction of post-surgical seizure relief and potential cognitive deficits secondary to anterior temporal lobectomy (ATL) are important to pre-surgical planning. Although the intracarotid amobarbital test (IAT) is predictive of post-ATL seizure outcome, development of non-invasive and more precise means for determining post-ATL seizure relief are needed. We previously reported on a technique utilizing functional MRI (fMRI) to evaluate the relative functional adequacy of mesial temporal lobe structures in preparation for ATL. In the present study, we report follow-up outcome data on eight temporal lobe epilepsy (TLE) patients 1-year post-ATL who were evaluated pre-surgically using IAT and fMRI. Functional memory lateralization using fMRI predicted post-ATL seizure outcome as effectively as the IAT. In general, asymmetry of functional mTL activation favouring the non-epileptic hemisphere was associated with seizure-free status at 1-year follow-up. Moreover, when combined, fMRI and IAT provided complementary data that resulted in improved prediction of post-operative seizure control compared with either procedure alone.

Original languageEnglish (US)
Pages (from-to)450-455
Number of pages6
JournalSeizure
Volume8
Issue number8
DOIs
StatePublished - Dec 1999
Externally publishedYes

Keywords

  • FMRI
  • IAT
  • Neuroimaging
  • Outcome
  • Seizures
  • Wada test

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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