CEREBRAL ANESTHETIZATION FOR LOCALIZATION OF SPEECH - THE CONTRIBUTION OF GARDNER,W.JAMES

In 1949, the neurologist Juhn Wada reported the first use of a new pro cedure for determining the localization of speech and language in neur ological patients: examination of the effects on speech and language a fter injecting a barbiturate, sodium amytal, into the internal carotid artery of each hemisphere in succession. By the 1960s, Wada's Intraca rotid Amobarbital Procedure, or IAP, had become the method of choice f or identifying the speech-dominant side in one kind of neurological pa tient, persons with epilepsy who are candidates for surgical resection , and it remains so today. In 1941, however, an American neurosurgeon, W. James Gardner, reported his use of a different anesthetization pro cedure for speech localization in neurological patients. Instead of in jecting sodium amytal through the blood supply, as in the IAP, Gardner injected procaine hydrochloride directly into cortical tissue. In thi s paper, we provide a brief biography of Gardner. We then discuss his method of cortical anesthetization, the theoretical and empirical back ground guiding his use of this method and his choice of patients, and, finally, the fate of Gardner's method within the scientific community . (C) 1997 Academic Press.