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Emotional outbursts and post-traumatic stress disorder during intracarotid amobarbital procedure

From the NYU–Mt. Sinai Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY.

Address correspondence and reprint requests to Dr. Orrin Devinsky, NYU–Mt. Sinai Comprehensive Epilepsy Center, 560 First Avenue, Rivergate Fourth Floor, New York, NY 10016.

Severe emotional outbursts (SEOs) during intracarotid amobarbital procedures (IAP) rarely jeopardize preoperative language and memory testing. Four of four patients (100%) with outbursts had experienced significant emotional trauma (three were raped and one witnessed a decapitation), compared with 26 of 546 patients (4.8%) without outbursts (² = 69.8, p < 0.0001). Evocative injections were ipsilateral to seizure focus. IAP may disrupt emotional balance in some traumatized patients. Counseling may prevent SEOs.

Key words: Wada procedure—Post-traumatic stress disorder—Emotion—Epilepsy—Valence hypothesis.