Handbook on the Neuropsychology of Epilepsy by William B. Barr & Chris Morrison

Author:William B. Barr & Chris Morrison
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Patient Selection

The first step in conducting clinical functional neuroimaging is determining who should have fMRI and Wada or more than one mapping method prior to surgery. Figure 8.2 provides an algorithm for making this decision. This algorithm is based on the empirical data supporting three contentions: (1) fMRI is suitable for mapping language (Binder, 2011), (2) fMRI predicts both language and memory outcome after ATL more accurately than Wada (Binder, Sabsevitz, et al., 2008; Sabsevitz et al., 2003), and (3) there is no empirical data showing that fMRI can predict or prevent amnesia. In situations where there is a risk for developing an amnestic syndrome (e.g., evidence of temporal lobe pathology contralateral to the side of seizure focus), a Wada alone or in addition to an fMRI is recommended.

Fig. 8.2Algorithm for determining when to conduct fMRI or Wada testing

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