A clinical case of the Wada test in a patient with structural pharmacoresistant epilepsy

Abstract

Wada test is an effective diagnostic method for determining the hemispheric localization of speech functions. The vast majority of epileptological centers use this technique in pre-surgical diagnosis in adult patients with medial temporal lobe epilepsy. According to international literature, the use of this test in the pediatric population is extremely rare due to the need for adequate contact with the patient. We present a clinical case of a patient with structural pharmacoresistant epilepsy caused by post-stroke changes in the left middle cerebral artery. Wada test was used as part of a pre-surgical examination to determine the lateralization of the patient’s speech function. The test results allowed determining the right hemisphere to be dominant in speech function. After the surgical intervention — transylviar periinsular functional hemispherectomy — the girl had no deterioration in speech functions, which confirmed the specificity and sensitivity of the Wada test in a child with impaired cognitive development.