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Application of Quantitative Electroencephalogram (QEEG) and Neurofeedback in a General Neurology Practice

J. LucasKoberda, MD,PhD, Andrew Moses

Tallahassee Neuro-Balance Center


Background Information


-Quantitative electroencephalography (QEEG) and Electrical Neuro imaging has been underutilized in general neurology practice for uncertain reasons .Most neurologist are not familiar with Neurofeedback (NFB)therefore, NFB has had very limited application in neurology practice and is not reimbursable by most health insurances.

-Recent advances in computer technology have made QEEG testing relatively inexpensive.


-QEEG is based on mathematical processing of 20-30 minutes of standard EEG recording which is able to condense the EEGdata to one page color-coded summary. This gives a neurologist unprecedented ability to look at summarized EEG information which was not previously possible with regular EEG.


-Unfortunately ,most US neurology residency training programs do not offer QEEG, Electrical Neuroimaging or NFB training in their curriculum, which resulted in very limited application ofthis modalities in general neurology practice. Review of previous literature revealed no consensus among US neurologists, whether QEEG should be widely used in general neurology practice

-Therefore, I have decided to analyze patients from my general neurology clinic where 150 subsequent QEEG cases were reviewed with special attention being made whether QEEG testing contributed to either patient’s diagnosis, decision making or treatment.  Patients interested in NFB therapy were also QEEG retested after approximately 20 NFB sessions for evaluation of possible objective improvement of previously identified brain waves abnormalities. Patient’s subjective responses of any improvement with NFB were also collected


Materials and Methods


This ismulti-case report based on 150 consecutive patients who completed QEEG in general neurology clinic due to various neurological problems over the period of September 2010-August 2011.  QEEG patients were divided into 5 groups based on their initial clinical presentation. The main groups included patients with seizures, headaches,head injury, cognitive problems and behavioral dysfunctions.


              Simple statistical analysis using% has been applied to all groups of patients. Patients work up was depending on the presenting problem and frequently in addition to general neurological examination included brain imaging (MRI or CT), and/or commercially available computerized neurocognitive testing (NeuroTrax Corp,Mindstreams assessment).


Group 1-Analysis of patients with working diagnosis of possible epilepsy, seizure,syncope, CVA, or MS


Summary


Group 1-Analysis of patients with working diagnosis of possible epilepsy, seizure,syncope, CVA, or MS