INTRACAROTID AMYTAL PROCEDURE EVALUATION OF HEMISPHERIC SPEECH AND MEMORY FUNCTION IN CHILDREN AND ADOLESCENTS

Forty-one patients between 6 and 17 years of age underwent the intracarotid Amytal procedure (IAP) to determine hemispheric speech dominance and memory capacity. Thirty-six patients demonstrated left-hemisphere speech dominance, four patients were right-hemisphere speech-dominant, and one patient demonstrated bilateral speech capability. The IAP memory results were not significantly correlated with age at the time of the IAP testing, Full-Scale IQ, or the dosage of sodium Amytal. Twenty-one of the 36 left-speech-dominant patients (58.3%) had a disparity in hemispheric memory performance. IAP memory studies correctly predicted side of surgery in 91% of patients undergoing temporal lobectomy (87% for left temporal lobectomy, 100% for right temporal lobectomy). We conclude that the IAP can be used to determine hemispheric speech dominance unambiguously in children as young as 7 years of age and adolescents. In addition, when it is known that seizures originate from the temporal lobe, the IAP is useful in determining the lateralization of epileptic foci.