Intracarotid amobarbital procedure and etomidate speech and memory test

The intracarotid amobarbital procedure (IAP) has for over 50 years been an important component of the presurgical investigation of patients with epilepsy who are candidates for surgical intervention as treatment for their seizures. Owing to increasing frequency and duration of amobarbital shortages,...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2009-08, Vol.36 Suppl 2, p.S51-S54
Main Authors: Jones-Gotman, M, Sziklas, V, Djordjevic, J
Format: Article
Language:English
Subjects:
Amobarbital - administration & dosage
Amobarbital - pharmacology
Drug Administration Routes
Electroencephalography
Epilepsy - diagnosis
Epilepsy - physiopathology
Etoposide - administration & dosage
Etoposide - pharmacology
Functional Laterality - drug effects
Functional Laterality - physiology
Humans
Hypnotics and Sedatives - administration & dosage
Memory - drug effects
Memory - physiology
Neuropsychological Tests
Preoperative Care - methods
Speech - drug effects
Speech - physiology
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Summary:The intracarotid amobarbital procedure (IAP) has for over 50 years been an important component of the presurgical investigation of patients with epilepsy who are candidates for surgical intervention as treatment for their seizures. Owing to increasing frequency and duration of amobarbital shortages, alternatives for this drug have been sought and implemented, but until now only the drug was changed, while the basic procedure remained essentially the same as that used with amobarbital. This paper describes the Montreal Neurological Institute experience using etomidate in place of amobarbital and introducing a significant change in the procedure: after an initial bolus injection, an infusion is used to maintain the level of hemianesthesia during critical test times. Results of 28 patients tested with this procedure are compared to results from 40 patients tested in the standard IAP.
ISSN:0317-1671