Abstracts

Rationale: The use of amobarbital in Wada test varied between epilepsy centers, with no unified dosing or protocols available to standardize its use. We aimed to determine the dose of amobarbital in the presurgical evaluations of patients with temporal lobe epilepsy (TLE).  Methods: A retrospective study of patients with TLE conducted between January 2004 and December 2018 in King Faisal Specialist Hospital and Research Centre – Jeddah. Those successfully underwent Wada test were studied. Memory and language were assessed using standardized testing performed by a neuropsychologist and a neurologist. Patient’s demographics were identified.  Results: A total of 65 patients were studied. The mean age was 30 years, (range; 16 - 52 years), where 27 of the patients were females (42%).  All patients had a normal neurological examination, including language and memory. The average dose of amobarbital given was 99.6 mg (range; 65.7–120 mg). There was no statistical difference between the dosing given to patients who passed or failed the memory testing (101.4 mg vs. 94.7 mg, P value > 0.1).Multivariate regression analysis showed that amobarbital dose needs to be adjusted the patient’s weight only for those older than 30 years of age, (P value < 0.05, 95% CI; 0.1 – 0.5). On average, an increase of amobarbital by 0.3 mg/kg was required for each year increase in age to successfully execute the Wada test.  Conclusions: No factors other than patient’s age could be identified to predict the response to amobarbital in Wada test. Establishing a universal protocol for Amobarbital dosing is challenging because of lacking dose determinants.  Funding: No funding