Preliminary study on Wada test with bolus injection of propofol into intracarotid artery

Objective To test the safety and validity of propofol used in Wada test for the purpose of assaying language,motor and memory function in intractable epilepsy patients who could not accomplish fMRI.Methods After digital substraction angiography(DSA),a certain dose of propofol was bolusly injected through the catheter into intracarotid artery(ICA) and produced contralateral hemiplegia.When the contralateral upper limb strength was lower than grade 3,language and memory functions were evaluated.30 minutes later,the other side of carotid catheterization was executed as well as neuropsychological test.Video-electroencephalography(V-EEG) was recorded through the whole procedure.Results There were 9 male and 3 female patients with the age range of 4-24 years-old and average age of 15 years-old.2 of 12 were epileptic encephalopathy,10 focal symptomatic epilepsy.Except for one case with posterior communicating artery openness in DSA,the other 11 cases were accomplished Wada test.Among these 11 patients,7 showed transient side effects without serious complication after injection narcotic,and 10 were operated for epilepsy.None of the operated patients developed obvious neurological deficit at postsurgical following.Conclusion It is safe and valid to apply bolus injection of propofol into intracarotid artery in Wada test to evaluate the language,motor and memory function of the cerebrum.