The utility of the intracarotid Amytal procedure in determining hemispheric speech lateralization in pediatric epilepsy patients undergoing surgery.

The usefulness of the intracarotid Amytal (amobarbital) procedure (also called the Wada procedure) in identifying hemispheric language dominance in pediatric patients has not been independently confirmed with intraoperative language mapping techniques. Currently, data are extrapolated from adult studies. To better establish the usefulness of the intracarotid Amytal procedure in identifying hemispheric language dominance in pediatric patients, we reviewed the records of 77 consecutive pediatric patients who underwent sodium amobarbital testing. Among these 77 subjects, 34 underwent intraoperative language mapping, the results of which all completely confirmed the Amytal results. It was also shown that among these pediatric epileptic patients who underwent Amytal testing, there existed not only a strong correlation between left-handedness and atypical speech lateralization (right, bilateral hemisphere), but also between right-sided hemiparesis (i.e., early left-hemisphere injury) and atypical speech.