Hippocampal memory function as reflected by the intracarotid sodium methohexital Wada test

The intracarotid amobarbital procedure (IAP) determines lateralization of memory function for predicting the risk of amnesia after epilepsy surgery. Shortages of amobarbital led to its substitution with sodium methohexital in the intracarotid methohexital procedure (IMP). We compared IAP scores (32 patients) with IMP scores (20 patients). Wada ipsilateral and contralateral memory scores were analyzed and compared, as was the relationship of these scores to the results of standard neuropsychological memory tests. There was no significant difference in Wada contralateral memory scores (first injection) between the IAP and IMP. Differences between the IAP and IMP in memory scores for the hemisphere ipsilateral to the epileptogenic focus (second injection) were significant (P = 0.01), patients who underwent the IMP manifesting a higher ipsilateral memory reserve. IAP scores related better to standard neuropsychological memory test scores than did IMP scores. The anesthetic drug used in Wada testing may affect lateralized memory assessment and prediction of postsurgical memory changes.