WADA results

[Travis from MN]

I have the initial summery of my WADA that was performed this week. The summery of the two hemispheres are very similar. The Dr's (and I) know from testing (V-eeg's) that the seizures occur on one side, in one region. I may not have read it correctly, but it looked as if the two were VERY similar in frequencies and brain wave results monitored.

The piece that I can't fully understand, and due to it not being fully analyzed yet (?), is the text at the end on the report. It said 'clinical correlation is requested'.

I understand that means they want to compare the results of the WADA with my entire case history. I guess I was expecting something more definitive in the summery of the report.

I remember during the WADA speech was effected on the one side, however I don't know if that was assumed it would happen, yet there was not a notation of it. I remember when they had me doing the countdown from 100 backwards I couldn't speak properly after about 89 or so (when the amibarbital really kicked in). In my case, the speech was severely effected. I could think clearly, but not verbalize it. It came out as scrambled.

When they did the other side speech was not effected. I do recall not being able to see what was on one page I was shown. I don't know if it wasn't in my line of sight, or if it was caused by the electrical activity in the brain.

Any insight or comments?? Are WADA test reports hard to understand?

--Travis

[Porkette]

Hi Travis,
When I had my WADA test done they found out that my speech was split down both sides of my brain, what caused my sz., and they found damage on the RTL with a possibility of brain damage on the LTL also. It wasn't until the did the
surgery on me that they were sure that their was damage on the left temporal lobe. When I had the test both sides of my brain were effected by my speech and they found my short term memory was terrible because the right hippocampus
had become hard and shrunk from yrs. of sz. If I may ask did they video tape your WADA test? If they did the Drs. might need to see the tape again to understand what all the details are before they can give you any info. I know I had to have
a Spect scan and a Pet scan after the Wada test so they could be sure. I wish you the best of luck and May God Bless You!

Sue

[Travis from MN]

Not sure if it was taped. The room was equipped with two overhead cameras I could see when on my back; so it's quite possible they did so the results can be reviewed again.

I know when they did the (getting notes) injection in the Left Artery speech went to heck once the drug kicked in. I could try to verbalize but could not speak in an understandable manner. I also remember what to me seemed like nearly passing out right after that injection until the doctor spoke loudly to keep me there. Right injection did not have any bearing on speech ability.

So verbal is primarily on my Left side from what I am understanding. So if they have to go in there, they will need to be careful. It had been speculated speech might have transferred over to the right side due to my brain not being fully developed when the tumor was removed when I was almost 6 yrs old.

PET/CT was done in July along with VEEG and Neuro Psych. They ran a SPECT 2 years ago at Mayo.
All that's left on my platter is a high resolution MRI (test study group) followed by the intercranial electrodes. From what the doc said that should be done by the end of the year. However that's speculating the time line assuming the MRI will be in working order shortly.

I may understand a good amount of the jargon the Dr's use, but when it gets down to frequencies observed in the brain and waveforms that's beyond my comprehension!

I need to pull out my book "Epilepsy: A Comprehensive Textbook" (3 vol book) and see if that helps at all.

--Travis

[Porkette]

Hi Travis,

You might want to check with your Dr. to see if the wada test was taped and tell them to check it over more than once. In regards to you speech I'm sure you know that a persons speech is on the left side of the brain
and that's why you had a hard time speaking when they put the left side of your brain to sleep. My neurosurgeon told me that is was more risky to do brain surgery on a person who is left handed and I am left handed that's
why I had so many detailed tests done and I was in surgery for 8 hrs. As my Drs. have told me I'm a rare case they haven't seen to many cases like mine that triggers sz.
Here's wishing You Well and May God Bless You!

Sue

[Travis from MN]

I'm just thinking on the silliest things. My hair is past the waist. I think how strange it will be if I go to a crew cut after having long hair for so many years! And hair is the least of my concerns if this happens.

I pulled out the books and located the articles relating to the wada. Need to read those over the next few days.

Yah I know speech center is on the left side. The tumor I had was below that deep towards the brain stem when it was removed in 1981. That is why I had to see a speech therapist for a short time to get that back in working order after the surgery. I can't remember if I was always right handed, or if before the operation I used the other hand dominant. Hard to remember a lot before 4 or 5 years old for most people in general.

--Travis

[Tattoo2]

Hi Travis, I did not have my head shaved nor hair cut in any way before surgery. The neurosurgeons did what they needed to after I went down. All they needed to do was to get clean sterile areas to work and shaved only the areas where the incisions would be. Shaved near where the right part would be then down then forward toward my ear. The incisions made in those areas were a 3 sided square of sorts. Pull the skin forward and hair comes too leaving skull to remove next. When done, and skull back in place, replace and affix the skin. Hair still in the middle and when bandages removed hair covered the incisions. They did a great job, but I think my neurosurgeon was an artist anyway. They told me they learned that they had been taking much too much hair than needed. They did it very cleanly so that I still had my coif when I left the hospital. You may not need a buzz cut and keep your locks.
Re the Wada, I am under the impression that speech and memory typically is located on the side opposite handedness. Right side of the brain controls the left side of body, so maybe that is why. The location of speech and memory can vary with the person, so the WADA is necessary. My team told me that both sides can share the two. I had surgery on the right and my speech and memory are located on the left. I was able to have general anesthesia and be asleep during surgery for that reason. That was a neat test! I wish you the best. Tattoo

[jingle]

Both times I had surgery (left temporal lobe) just the left side of my head - in FRONT of my ear! - was shaved down from the left top of my head.
Just a small amount of hair was removed so it was easy to cover.

I've tried and tried to upload a photo of "me" but I can't make it work

[howdydave]

I was disqualified from surgery just before I had my wada.

The whole objective is to find out which functions might be effected if they chop out a part of your brain. You need to know this when assessing risks.

[Travis from MN]

They did a 3 Tesla MRI last December, and a 1.5 (or so) in January or so. They have NOT conducted an fMRI. I was reading an article comparing the results of the WADA and the fMRI last night. Doesn't sound like both are needed, it sounded like one or the other.

I know how they opened the skull when I was 5. It was like a reverse question mark from behind the ear to the front above the eye. Back then (early 80's) they just shaved the half of the head they needed to get at.

That' good to hear Tattoo. I know the one they have on my case sounds VERY talented from the bio. In conjunction with all the other Dr's it looks promising. I'm just in the holding pattern now until otherwise told.

Don't worry jingle. This will only be the second time my skull may be opened. A lot has improved the last 30 years in cranial techniques.

--Travis

[Travis from MN]

Sounds like it's on! I met the neurosurgeon Thursday and with video conferencing included my folks to calm their nerves. She said the 7T MRI and intercrainal EEG were not needed for her. The previous 3T, WADA, and VEEG would be enough to go on.

A ballpark date is NEXT MONTH for surgery. About 5 days or less in hospital, then possibly one week in supervised facility for recovery is what I was told.

--Travis

[Tattoo2]

Great! I am glad for you. We have come very far in surgical epilepsy care!! Did you ask the neurosurgeon's success rate? Not the bio. Ask them. I did. How many epilepsy surgery cases has he done successfully? I wanted to know. Why the facility afterward? I am not familiar with that. I went home alone. You have all of us with you for sure!!
I want to work in epilepsy sooo bad but can't find a Center in my state I like. Don't want to move still in school but sure do need to find a job in it. My calling for sure. I wish you well and keep us posted here. Tattoo

[jingle]

IMHO - that surgery is fantastic news!! Best wishes

[Travis from MN]

She has a great bio. Done a good number or surgeries. Education history and externships/internships were at good facilities. It was asked at the meeting last week what the chances are of getting rid of seizures. Dr's always squirm when they are asked percentages. She said there was a high chance I'd be seizure free.

I think the reason for post operation monitoring the week following discharge was "just in case". That is uncertain if it will be done. I live in a building of persons with disabilities of all sorts. There are 2 residents who are nurses, so worst case one of them can help.

They are sending the packet off to me for the surgery.
I just saw another Dr yesterday for the genetic condition I have. I was informed what I thought was a result of a seizure ,biting my tongue, was actually one of two tumors on it. The rest of that appointment was a gab session. Dr knows I'm not an endangered case, so they just keep an eye on me every year. I like appointments that are light like that!!


Slightly off this topic thread, I have a question for ya'll. Does ANYBODY know the "Epilepsy Foundation Concerns Index"? I think it's to evaluate the QOL of patients, often pre/post surgery. Similar to Davinski's (sp?) evaluation scale I think. I have encountered references to it numerous times in articles I'm reading and have no idea what it entails. It was referenced in a 1999 article in Neurology according to references in the articles. (yes I'm reading technical books here!)

Thanks everybody. I'll try to keep ya up to date if I can. In ICU I don't think I'll be allowed to have my portable...Internet withdrawal.

--Travis

[Tattoo2]

I googled the Concern's Index you mentioned and found this article. It seems that the EFA used a global score for all the many dimensions assessed, and it was felt that things could be missed. Three docs from the Comprehensive Center that did my surgery are listed as participating in this study of the Concern's Index who concluded that important details could be left out. I was so pleased. Those are my special docs.
I am not sure what experience and training those who initially did the Index had. Maybe that has something to do with the fact that is was not all inclusive. Tattoo
This is a quote from the abstract. "We conclude that the Epilepsy Foundation Concerns Index is multidimensional, and using a global score based on all items may mask specific concerns that may be relevant when applied to individual patients."
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[Travis from MN]

I was told this afternoon the 7 Tesla MRI was up and running... then asked "Can you come down tomorrow? We have a slot at midday." Well...no time to call for medical transport. I'm eating a cab fare to get down there. Taking a much cheaper transport back home.

This may end up for the better having it done before the surgery. See if it gives a better picture of the structure.

Should be interesting to see how the 7T images come out. From what I have heard, they are much clearer signal to noise than the 3T. The 7 is still in "trial" phase regarding Epilepsy, even though it's been around almost as long as the 3. The bore (opening size) is the same as the 3. Found out this location has a 10.6 (10 something) arriving NeXT year. Only 2cm smaller bore than the 3 and 7T.

--Travis