Seizures during intracarotid methohexital and amobarbital testing

Tobias Loddenkemper; Gabriel Möddel; Stephan U. Schuele; Elaine Wyllie; Harold H. Morris

doi:10.1016/j.yebeh.2006.09.001

Seizures during intracarotid methohexital and amobarbital testing

Tobias Loddenkemper^*, Gabriel Möddel, Stephan U. Schuele, Elaine Wyllie, Harold H. Morris

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Background: Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures. Methods: A retrospective chart review of 760 intracarotid amobarbital and methohexital tests was performed to determine the frequency of seizures associated with preoperative intracarotid barbiturate testing for language and memory lateralization. Results: Sixteen patients (2.1%) who had seizures were found. In 3 patients, seizures occurred prior to barbiturate injection, and in 13, following barbiturate injection. After injection of amobarbital, 4 of 538 patients (0.7%) had a seizure. Nine of 222 patients had a seizure after methohexital injection (4.1%) (P = 0.001). Conclusion: Patients with a previous history of epilepsy may be at higher risk for seizures after methohexital injection as compared with amobarbital injection.

Original language	English (US)
Pages (from-to)	49-54
Number of pages	6
Journal	Epilepsy and Behavior
Volume	10
Issue number	1
DOIs	https://doi.org/10.1016/j.yebeh.2006.09.001
State	Published - Feb 2007

Keywords

Intracarotid amobarbital test
Methohexital
Seizures
Wada test

ASJC Scopus subject areas

Neurology
Clinical Neurology
Behavioral Neuroscience

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10.1016/j.yebeh.2006.09.001

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title = "Seizures during intracarotid methohexital and amobarbital testing",

abstract = "Background: Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures. Methods: A retrospective chart review of 760 intracarotid amobarbital and methohexital tests was performed to determine the frequency of seizures associated with preoperative intracarotid barbiturate testing for language and memory lateralization. Results: Sixteen patients (2.1%) who had seizures were found. In 3 patients, seizures occurred prior to barbiturate injection, and in 13, following barbiturate injection. After injection of amobarbital, 4 of 538 patients (0.7%) had a seizure. Nine of 222 patients had a seizure after methohexital injection (4.1%) (P = 0.001). Conclusion: Patients with a previous history of epilepsy may be at higher risk for seizures after methohexital injection as compared with amobarbital injection.",

keywords = "Intracarotid amobarbital test, Methohexital, Seizures, Wada test",

author = "Tobias Loddenkemper and Gabriel M{\"o}ddel and Schuele, {Stephan U.} and Elaine Wyllie and Morris, {Harold H.}",

note = "Funding Information: The study was approved by the Cleveland Clinic Institutional Review Board. T.L. was supported by Innovative Medizinische Forschung, WWU M{\"u}nster, Germany (FoeKz. LO 610101).",

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AU - Schuele, Stephan U.

AU - Wyllie, Elaine

AU - Morris, Harold H.

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N2 - Background: Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures. Methods: A retrospective chart review of 760 intracarotid amobarbital and methohexital tests was performed to determine the frequency of seizures associated with preoperative intracarotid barbiturate testing for language and memory lateralization. Results: Sixteen patients (2.1%) who had seizures were found. In 3 patients, seizures occurred prior to barbiturate injection, and in 13, following barbiturate injection. After injection of amobarbital, 4 of 538 patients (0.7%) had a seizure. Nine of 222 patients had a seizure after methohexital injection (4.1%) (P = 0.001). Conclusion: Patients with a previous history of epilepsy may be at higher risk for seizures after methohexital injection as compared with amobarbital injection.

AB - Background: Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures. Methods: A retrospective chart review of 760 intracarotid amobarbital and methohexital tests was performed to determine the frequency of seizures associated with preoperative intracarotid barbiturate testing for language and memory lateralization. Results: Sixteen patients (2.1%) who had seizures were found. In 3 patients, seizures occurred prior to barbiturate injection, and in 13, following barbiturate injection. After injection of amobarbital, 4 of 538 patients (0.7%) had a seizure. Nine of 222 patients had a seizure after methohexital injection (4.1%) (P = 0.001). Conclusion: Patients with a previous history of epilepsy may be at higher risk for seizures after methohexital injection as compared with amobarbital injection.

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Seizures during intracarotid methohexital and amobarbital testing

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