Factors Affecting Intracarotid Amobarbital Procedure (IAP) Memory Performance in Children and Adolescents
Abstract number :
2.251
Submission category :
Year :
2000
Submission ID :
2569
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Ann Hempel, Gail L Risse, Frank J Ritter, Michael D Frost, Minnesota Epilepsy Group, PA, St. Paul, MN.
RATIONALE: Previous studies have suggested that children s memory performance on the IAP is associated with intellectual functioning and dominant (Dom) vs. nondominant (ND) hemisphere injection. This study was aimed at assessing these and other factors that are associated with successful IAP memory performance in children and adolescents. METHODS: Patients included seven young (5-7 years), 25 middle (8-11 years) and 42 older (12-17) children and adolescents who underwent the IAP as part of their presurgical evaluation. Patients were included if hemispheric language dominance was successfully classified, they underwent injection of both the left and right hemispheres, and side of seizure onset was unilateral. Data were analyzed with the chi-square, Fisher Exact, and Sign tests. RESULTS: Obtundation or agitation was associated with increased IAP memory failure following injection of either the side ipsilateral (Ipsi) or contralateral (Contra) to seizure onset. Obtundation or agitation was not more often observed among younger or mentally impaired patients. Among those who did not experience agitation or obtundation, patients in the young and middle groups were as likely as adolescents to pass Ipsi and Contra injections. Patients were more likely to pass Dom than ND injection (p=.04), and patients with IQ<70 were somewhat less likely than normal IQ patients to pass Dom injection (p=.13). Patients were more likely to pass Ipsi than Contra injection, but only when the Ipsi hemisphere was also ND (p=.02). Patients with IQ<70 were less likely to pass Contra injection; this appeared due specifically to the higher incidence of Contra=Dom in this group than in normal IQ patients (p=.15). CONCLUSIONS: Age, in itself, is not related to satisfactory IAP memory performance, nor is side of injection relative to side of seizure onset. However, children/adolescents are less likely to pass Dom than ND injection, and passing Dom injection is even less likely in low IQ patients. These data will be examined further with respect to order of injection and dose of amobarbital.