Pre-surgical intervention techniques

To localise the cognitive functions related with the area of the brain which requires surgical intervention, we can use different techniques. The WADA test, the FMRI, functional magnetic resonance imaging, and Magneto-electro-encephalography. The WADA test is used to determine hemispheric representation of language and memory functioning, through selective anesthetization of each cerebral hemisphere amobarbital or another short acting barbiturate is injected into the internal carotid artery to temporarily anesthetise the hemisphere of surgical interest. The WADA test has been used by most epilepsy surgery centres to assess risk for language and memory morbidity following temporal lobe activity. Now less invasive methods for lateralization of language are available. For example functional MRI or magnitudes encephalography, but WADA test is still used.

Functional magnetic resonance is a replacement of WADA for lateralisation. It is not invasive, requires no exposure to radiations Provides information on lateralisation and localisation. Magneto-electro-encephalographic provides a direct measure of neural activity with good temporary resolution. It is used for more precise Identification of epileptiform abnormalities. Recently, there has been much emerging literature on the role of MEG in localisation of language in presurgical epilepsy evaluation. It is necessary to evaluate the individual’s expectations with regard to surgery. The social support network for the post operative period and their emotional stability to undergo a neurosurgical intervention.