Shah-Naz H Khan and Andrew J. RingerHandbook of Neuroendovascular Techniqueshttps://doi.org/10.1007/978-3-319-52936-3_17

17. Neurophysiological Tests

Shah-Naz H. Khan^{1, 2} and Andrew J. Ringer³

(1)

Institute of General and Endovascular Neurosurgery (IGEN), Flint, MI, USA

(2)

Department of Surgery, College of Human Medicine, Michigan State University, Flint, MI, USA

(3)

Mayfield Clinic, Chief of Neurosciences, TriHealth System, Cincinnati, OH, USA

Shah-Naz H. Khan

Keywords

WADA testSodium AmytalLidocaineSpeech dominanceNeuronal activityAxonal activity

WADA Test

To determine hemispheric dominance for speech .
Test injection prior to embolization of a vessel feeding an AVM when the functional significance of a vessel or pedicle in question is unclear, e.g., due to inadequate angiographic visualization or embolization of a region with high risks (such as spinal cord or in the brain).
When suppression of both neuronal and axonal activity is desired, amytal injection is followed by 40 mg lidocaine injection (e.g., in spinal AVMs).

Fluids only for breakfast.
Continue prescribed medications (including ASA and antihypertensives) except antiseizure drugs, which would have been withheld by neurologist.
Labs: CBC, APTT, INR, electrolytes, BUN, CR.
ß-HCG for females of reproductive age group.
Insert IV and commence 0.9% N.S. at 75 cc/hr.
Consent the patient.