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Clínica de Epilepsia | Trabalhos em Congressos

CEREBRAL DOMINANCE AS DETERMINED BY THE INTRACAROTID AMYTAL PROCEDURE (IAP) AND THE DICHOTIC WORDS LISTENING TEST (DWLT)

A.R. CANER-CUKIERT, A. CUKIERT.

Department of Neurology and Neurosurgery, School of Medicine, University of Sao Paulo, Sao Paulo SP, BRAZIL; Sao Paulo Neurologic Institute.

RATIONALE - To study the role of the DWLT in the non-invasive determination of the cerebral dominance using IAP’s results as a gold standard.

METHODS - Twenty-seven epileptic patients were submitted to both the IAP and the DWLT. Seventeen patients had bitemporal, 5 unitemporal, 4 frontal and 1 left parietal foci. The DWLT was administered in an out patient basis as part of the basic neuropsychological evaluation. The IAP included bilateral carotid injections in all patients. Twenty-one patients were right and 6 left-handed.

RESULTS - Two of the right-handed patients had right hemispheric dominance as determined by the IAP. One of these patients had a marked left ear advantage and the other had no ear asymmetry at the DWLT. Three of the left-handed patients showed right hemispheric dominance as determined by the IAP. Two of these patients showed a marked left ear advantage and 1 showed no ear asymmetry at the DWLT. Overall, all patients with a left ear advantage higher than 15 had right and all patients with a right ear advantage higher than 5 had left cerebral dominance as determined by the IAP.

CONCLUSIONS - The DWLT should be included in the basic neuropsychological evaluation of epileptics. A left ear advantage higher than 15 and a right ear advantage higher than 5 strongly suggests a right or left cerebral dominance, respectively. In patients with no clear ear asymmetry there is overlap of the cerebral dominance results.