The Spinal Wada Test: Adapting a Neurointerventional Technique for Bronchial Artery Embolization

Excerpt

The spinal Wada test, first described by Doppman et al. in 1986, is an adaptation of the protocol of a Wada-Rasmussen test. Various doses of phenobarbital (2.5–10 mg) and lidocaine (2.5–20 mg) were injected directly into the artery of Adamkiewicz of adult rhesus monkeys resulting in a transient lower extremity paraplegia with a dose-dependent duration of symptoms ranging from 3 to 30 min [1]. The authors suggested that the spinal Wada could provide a reproducible and reversible means of evaluating risk of spinal cord infarction prior to embolic procedures. Since being described in 1986, there has been infrequent mention of the technique in the interventional radiology literature and no further large-scale studies have been performed to evaluate optimal medication dosing, patient selection, or risks of the procedure. Although it has largely faded from the Interventional Radiology, the spinal Wada test has been adapted in neurointerventional and neurosurgical procedures, and is more commonly referred to as “provocative testing.” …