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Epilepsy Surgery Evaluation |
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| MRI | Video EEG | Neuropsychological Testing | Wada | PET | SPECT | MEG | Implanted Electrodes |
Wada
The Wada is a diagnostic test to determine which side of your brain is dominant for speech and memory. The test is essential to determine which area of the brain may be removed if your seizures come from the side of your brain that also controls your speech and memory. This test will be done at the same time that the cerebral Arteriogram is done. This test is minimally invasive and some portions may be uncomfortable.
Before the Procedure
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You will need to have blood work (PT, PTT) that tells us how quickly your blood clots. It is important to know this information to avoid any problems. If the results are abnormal your Wada will have to be postponed. You will be given a prescription for the blood work at the time you are scheduled for the procedure.
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Notify your physician if you are taking any medication that may affect blood clotting (Heparin, Coumadin, Aspirin, Goody's Power, Plavix, etc.), have a known bleeding disorder, have an allergy to Iodine or Contrast ("Dye") used in Radiology procedures, are diabetic or have a history of renal disease.
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You cannot eat or drink after 12:00am the night before your test.
Procedure
The Wada/Cerebral Arteriogram involves both Neurology/Neuropsychology and Interventional Neuroradiology. Performed in Radiology, the procedure uses a form of X-ray for acquiring the images needed to do the study. You will be awake during the procedure.
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You will lie flat on a table lying on your back and the procedure is performed through your upper leg.
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Your upper leg is cleaned and an anesthetic will be injected to "numb" the area. A small stick and burning sensation similar to how a tooth feels to be anesthetized will be felt for a few seconds. Once the skin is numb, a small IV-like device (sheath) is placed temporarily into the leg artery are access.
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Using a small catheter (tube), the appropriate neck vessel is selected and images are taken before the Wada test.
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Once the images are reviewed, Sodium Amytal - a medicine used to temporarily put part of the brain to sleep - will be injected for the Wada testing. This medication may make you feel sleepy and unable to move one side of your body. This is temporary and only last 3-5 minutes. It is not painful. at this time, the neuropsychologist will begin testing.
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Once testing is complete and the medicine has worn off (approximately 30 minutes), the opposite side of the brain is tested in the same way. Each side of the brain is tested separately but does not require use of the opposite leg.
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Once both sides are tested, the catheter and sheath are removed and pressure held over the entry site on the leg until bleeding stops, usually 10-15 minutes.
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No stitches or sutures are necessary. Only a small needle-stick hole is noticeable after the procedure. A regular band-aid is all that is required for this site.
After the Procedure
You will be taken to a room in the hospital for observation for approximately 8 hours. You must lay flat on your back during for 4 hours and then your head may be elevated to 45 degrees for the remaining 4 hours of observation. This is to prevent a hematoma to the entry site. You will be able to watch TV, eat lunch, and sleep during this time. You are not admitted to the hospital and will go home the same day of your test. You must have someone that can drive you home after the procedure. Your family will be allowed to join you in the recovery room.
You may resume normal activity as tolerated 24 hours after the procedure, however you should avoid prolonged sitting until the puncture site from the arteriogram heals.
You may shower 24 hours after the procedure.
For 5 days after the procedure you should not not soak in a tub or go swimming, lift anything over 10 pounds, or do strenuous activity.
