2026 American Academy of Neurology Abstract Website

Objective:

WADA test is considered “gold standard” in pre-surgical language lateralization for patients with refractory epilepsy considering epilepsy surgery and typically administered in English.

Background:

Limited proficiency in English presents challenges for conducting Wada testing. Many refractory epilepsy patients in the U.S.A. speak English as a second language, often with varying levels of fluency and some not at all. It is ideal to administer the test in a patient's native language with interpreters.

Design/Methods:

Three patients with no or little English-speaking abilities had their WADA test performed with the help of trained medical interpreters following standard WADA Testing protocol.

1:28 years old right-handed African female with intractable right mesial temporal epilepsy who speaks Nuer had WADA that demonstrated language on the Left hemisphere with memory recall of 2/8 on the right and 8/8 on the left . She successfully underwent right temporal lobectomy.

2:42 years old right-handed Hispanic female with refractory left mesial temporal epilepsy underwent WADA Test which showed left hemisphere language and 6/8 recall on the left and 8/8 on right. She underwent a successful left temporal lobectomy.

3:28 years old Nepalese male with static encephalopathy and intractable epilepsy had WADA Test done with interpreter, primarily for language lateralization, which was lateralized to the left hemisphere. He underwent intracranial EEG monitoring and resective surgery of the left temporal lobe DNET tumor with no loss of language function.

Results:

Three non-English speakers underwent WADA Test successfully and had no significant postoperative loss of memory or language function. Standard protocol of WADA test was followed and was implemented with the help of medical interpreters. Detailed pre procedural planning and patient education was very useful.

Conclusions:

It is possible to successfully undertake WADA Tests in patients with refractory epilepsy who are not proficient in English. The standard WADA protocol can be followed with the help of interpreters.