Document Detail

Language lateralization in patients with temporal lobe epilepsy: a comparison of functional transcranial Doppler sonography and the Wada test.
MedLine Citation:
PMID:  12880847     Owner:  NLM     Status:  MEDLINE    
This study prospectively investigates whether noninvasive functional transcranial Doppler sonography (fTCD) is a useful tool to determine hemispheric language lateralization in the presurgical evaluation of patients with medically intractable temporal lobe epilepsy (TLE). fTCD results were compared with the Wada test as the gold standard. Wada test and fTCD were performed in 13 patients suffering from TLE. fTCD continuously measured blood flow velocities in both middle cerebral arteries, while the patient was performing a cued word generation task. During the Wada test, spontaneous speech, comprehension, reading, naming, and repetition were investigated. A laterality index (LI) was obtained by both procedures. Due to a lack of an acoustic temporal bone window, fTCD could not be performed in two patients (15%). In 9 of the remaining 11 patients hemispheric language dominance was found on the left side, in 1 patient on the right side, and 1 patient showed bihemispheric language representation. In all patients fTCD and the Wada test were in good agreement regarding hemispheric language lateralization, and the LI of both techniques were highly correlated (r = 0.776, P = 0.005). fTCD gives predictions of hemispheric language dominance consistent with the Wada test results even in children, patients with low IQ, and nonnative speakers. It is an alternative to the Wada test in determining language lateralization in patients with temporal lobe epilepsy.
Susanne Knake; Anja Haag; Hajo M Hamer; Christine Dittmer; Siegfried Bien; Wolfgang H Oertel; Felix Rosenow
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  NeuroImage     Volume:  19     ISSN:  1053-8119     ISO Abbreviation:  Neuroimage     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-25     Completed Date:  2003-09-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9215515     Medline TA:  Neuroimage     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1228-32     Citation Subset:  IM    
Department of Neurology, Interdisciplinary Epilepsy Center, Philipps-University, Marburg, Germany.
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MeSH Terms
Amobarbital / administration & dosage,  diagnostic use*
Carotid Arteries
Epilepsy, Temporal Lobe / physiopathology*,  surgery,  ultrasonography
Functional Laterality / physiology*
Hypnotics and Sedatives / administration & dosage,  diagnostic use*
Injections, Intra-Arterial
Memory / physiology*
Middle Aged
Neurosurgical Procedures
Prospective Studies
Ultrasonography, Doppler, Transcranial
Reg. No./Substance:
0/Hypnotics and Sedatives; 57-43-2/Amobarbital

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