Let's learn about the Wada test that is performed before your brain surgery.

You've probably been told by a doctor that you need to have a WADA test before brain surgery. That might sound a little scary, right? But this is actually a very important test for your safety. So today, let's talk about this WADA test in a simple way that you can understand.

What is this Wada Test?

Simply put, the Vodka test is a special test that your doctor performs, especially before surgery for epilepsy or a brain tumor. It helps them answer two main questions:

1. Which side of the brain controls your language abilities? (That is, the left side or the right side.)

2. How important is each side of the brain to your memory?

This information is very important for the doctor who performs your brain surgery, the neurosurgeon, because it helps them assess in advance what kind of impact your speech or memory might have after the surgery.

This test was first performed in 1949 by Dr. Juhn Wada. That's why it's called the Wada test. Sometimes other names are used for it, and your doctor may call it:

• Intracarotid amobarbital test
• Sodium amytal test
• Amytal study

Before epilepsy surgery, doctors may use other types of tests, for example:

• Functional magnetic resonance imaging scan (fMRI)
• Transcranial magnetic stimulation (`Transcranial magnetic stimulation`)
• Neuropsychiatric testing

Which side of the brain controls language?

For most people, that is, for the majority of us right-handed people, the language and speaking ability is controlled by the left side of the brain. However, this is not the case for everyone. This can sometimes be different, especially for left-handed people. That is why it is important to do the Voda test and find out exactly.

How is memory controlled?

Both sides of the brain can control memory. Typically, people who are left-brain dominant for language have their left side more important for verbal memory, and their right side more important for visual memory, which is remembering things like pictures. The Vodka test can help your doctor determine which side of the brain is better at memory.

Who can do this test?

The Voda test can be done on adults as well as children. However, if it is a child, he or she must be old enough to participate in this test, able to speak and understand things. Imagine, a small baby does not understand the words shown in this test. Therefore, this is usually done on children who are a little older and of an understanding age.

Who performs the Voda test? (Expert team)

This is not something that a single person does. The Voda test is performed by a team of specialist doctors. They are:

• Epileptologist: This is a neurologist who specializes in epilepsy.
• Interventional Neuroradiologist: This is a doctor who specializes in catheter-based tests. He or she will insert a catheter into your carotid artery to administer anesthesia to your brain during the VODA test.
• Neuropsychologist: A person who specializes in how brain conditions affect your behavior and thinking skills.

How do you prepare for the Voda test?

Your doctor may tell you to stop taking certain medications about two weeks before the test. For example, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and blood thinners. However, you should continue to take any other medications your doctor has prescribed for as long as he or she tells you. It is very important to tell your doctor in advance if you have any allergies to any medications.

What happens before the Voda test?

Before the test, you will be asked to change into a hospital gown. Then, some hair will be removed from your armpit area, as this is where a blood vessel will be inserted. In the examination room, electrodes will be placed on your scalp to prepare you for an electroencephalogram (EEG). This EEG measures your brain activity during the test.

Then, the doctor will numb the skin in your groin area. When the area feels numb, they will insert a needle into a blood vessel in your leg. Next, they will insert a long, thin tube called a catheter into that blood vessel. The catheter will be threaded up to the large blood vessel in your neck called the carotid artery. While this is happening, you may feel a metallic taste in your mouth and a warm sensation. It may feel like a slight stinging sensation, but it should not be painful.

Before the Voda test, you will have an angiogram. The angiogram checks the blood flow in your brain to make sure it is safe to do the Voda test.

How to do the Voda test correctly?

Now comes the important part. Your interventional neuroradiologist will inject anesthetic medication through a catheter into either your left or right carotid artery, temporarily numbing only one side of your brain. Imagine if the medication went into your right carotid artery, the right side of your brain wouldn't be able to communicate with the left side of your body.

During this time, you may see stars, feel a pressure behind your eyes, and feel your face getting hot. Also, the side of your body opposite the side that was sedated will go numb for a while. This means you won't be able to move your limbs. Doctors will look at the EEG recordings to confirm whether that side of your brain has gone to sleep.

Once it is confirmed that one side of the brain has gone to sleep, an epileptologist or neuropsychologist will test your ability to speak. They will also show you some cards with words and pictures. They will tell you to try to remember what you see. At this time, you may feel weak and have difficulty speaking. This is normal. You may even fall asleep.

What if I can't talk during the test?

Sometimes, you may not be able to speak during the test. Also, in some cases, the benefit of this test may be reduced:

• If the children are under 10 years old.
• If a seizure occurs during the test.
• Those with an intelligence quotient (IQ) of less than 70.

But don't worry, if you feel any fear or anxiety, the doctors and nurses are there to help.

The effects of the anesthetic wear off in a few minutes, and then the side of your brain that was numbed wakes up again. At that time, the doctor will ask you what you remember. If you don't remember, they will show you the cards one by one again and ask if you have seen them before. It's okay if you don't remember what was on the cards, that's normal.

After a while, the doctors put the other side of your brain to sleep in the same way. They take the catheter back a little and thread it into the carotid artery on the other side. They do another angiogram. They show you a different set of cards again. When you're fully awake, they ask you again what was on the cards.

Were you awake when you took the Voda test?

Yes, you will be awake throughout this entire examination. The doctors will do this by talking to you.

How long does this test take?

The time it takes for a Voda test can vary slightly from hospital to hospital, but it usually takes about three to four hours. Often, both sides of the brain are tested in the same test. One side is done, and you wait a while until you're fully recovered before doing the other side.

What happens after the test?

After the test, you will need to rest in the recovery unit. The doctors and nurses will come in from time to time to check your leg for a pulse where the catheter was inserted. They will also check the bandage covering the wound in your groin, and make sure your sense of touch has fully returned. All of this is done to make sure that the blood flow in your leg is normal.

You will usually be allowed to go home the same evening. Doctors will tell you to avoid strenuous activities for 24 to 48 hours after you go home.

Is the Voda test invasive? Are there any risks or side effects?

The VODA test is generally safe and low-risk . If you experience any side effects, they will likely be some pain at the site of the catheter insertion (as the numbing medication wears off). However, there are very rare complications that can occur:

• Seizure.
• Brain dysfunction (Encephalopathy).
• A stroke-like condition.

Because this is an invasive procedure, there is a small risk of bleeding and infection. This risk may be slightly higher, but still relatively low, in the following cases:

• If you are over 65 years old.
• If you have atherosclerosis (hardening of the blood vessels).
• If you have high cholesterol levels.

What do the results of the Voda test say?

The Voda test can help your team find out exactly which side of your brain is responsible for language and which side is responsible for memory. They compare this data with previous tests that show where in your brain epilepsy occurs. With all this information, your surgeon can decide whether brain surgery could put your language and memory at risk.

Epilepsy can be scary, and brain surgery can be even scarier. But, fortunately, your doctors are equipped with the tools and knowledge to help you prevent problems with your language and memory. The Vodka test is one such important tool they use. If you have any questions about this test, don't hesitate to talk to your doctor.

Finally, things to remember (Take-Home Message)

Okay, so now you have a good understanding of the Wada Test. In short:

• This is an important test done before brain surgery to find out information about your language and memory skills .
• This allows doctors to plan to minimize possible side effects from surgery.
• You will be awake during the test, so there is nothing to be afraid of.
• Although it is generally a safe test , as with any medical procedure, there are some minor risks, which your doctor will explain to you.
• If you have any questions, fears, or doubts , discuss them with your doctor and resolve them.

Remember, all of this is for your own health and safety.

` Voda test, brain surgery, epilepsy, language center, memory, neurology, medical tests