[Linda (Mom) in CT]

Hi,
What is a QEEG?

Hey Linda,

Here is a website that does a very thorough job explaining what a QEEG is and does. http://www.qeeg.com/qeegfact.html
Please refer to it for more detailed information. Basically, a QEEG is an electrical map of the brain. Our brains are biochemical and bioelectrical organs. It operates the same way your television or computer does, by moving electrons around in order to "do its job." When this happens, an electrical signal is given off. This signal is otherwise known as 'brain waves.' Different speeds of brain waves correspond to different states of mind. The signals are measured in Hertz and grouped together for easy classification. For more on this, please refer to the website.

What the QEEG does is measure a persons brainwaves from 1 - 40 Hz. It is doing this to ascertain what frequencies are dominant in what area of the brain. A healthy brain shouldn't have any dominant frequencies which would allow for easy flow between different mental states. A person who has a dominant frequency, in your daughter's case it is probably 1-5 Hz and 20-30 Hz, is stuck in these corresponding states of mind. The QEEG also measure coherence and phase relationships. This is basically measuring how well the brain is communicating with itself.

The reason why I suggested getting a QEEG instead of a SPECT scan is because QEEG's are a fraction of the price that SPECT scans are. I believe that SPECT scans cost around $3000 and QEEG's cost around $500. Like I said earlier, they basically tell you the same thing because the brainwave frequencies usually correlate to blood flow. However, one of the advantages of a SPECT scan is that it does give you a 3D image whereas the QEEG is only a 2D image of the brain.

Now, why would you get a QEEG done? Basically for two reasons. The first is for litigation purposes. If you are trying to get SS disability or if you are involved in a lawsuit as a result of the brain injury because this will provide evidence that an injury has taken place. The second reason would be to do neurofeedback to train out the dominant frequencies and incoherences. Of course, someone could get one just for the sake of knowing what is wrong with them.

So, that is pretty much it in a nutshell. Hope it helps.

[Linda (Mom) in CT]

How is the QEEG done?

Is it similar to the EEG - attaching the leads to the scalp? Is it any different?

Linda

The QEEG is done by placing a cap that looks like a swimmer's cap onto the head. There are somewhere in the neighborhood of 25-30 electrodes inserted onto the cap. During the test, the client is asked to do a series of tasks such as read, arithmetic, relax with eyes closed, recall general knowledge, etc... This is then analyzed and compared against a normal population.

It is much more sensitive than a regular EEG that hospitals use. The standard EEG is basically looking for seizure activity and usually nothing more. A person who doesn't experience seizure activity will have a normal EEG; however, if they have had a concussion, it will show up on the QEEG.

[Mark in Idaho]

Linda,

Most standard EEGs use 13 electrodes, including one grounded to an ear. Most qEEG's are done using an 18 to 24 electrode cap. They are not uncommon with up to 64 or more electrodes. They are much less expensive than a SPECT. I have had a SPECT and 4 different qEEGs. The important issue about a qEEG is the physician. Most physicians or therapists have limited knowledge of qEEG waveforms. They often rely on a computer to analyze the waveforms. Some do it in their office. Others send the waveform record to a specialist for analysis.
Unless you find a specialist locally, I would recommend finding a specialist who can refer you to a local therapist/qEEG tech.

btw, qEEG stands for quantitative EEG. It just refers to the way the electrical data is processed to find the specific abnormalities. Fast Fourier Transformation (FFT) is the algorithm used most often. The result can then be compared to a database of control (non-symptomatic) and symptomatic subjects Normalized to be of a similar age and gender, etc. This allows the physician to group the subject with others and compare the dysfunctions common to the group. There are databases for ADD/ADHD and MTBI. Most research has been done in the ADD/ADHD area.

QEEG is used in litigation is some instances but it takes a very knowledgeable attorney. It is not used in Social Security Disability applications. The SSDI process does not recognize qEEG as valid even though qEEG has very high validity and accuracy rates, in the high 80 to 90 percents. It has very low false positive results, almost statistically insignificant.

Most neurologist do not use qEEG but rather rely on standard EEG procedures. Standard EEG's will often be normal while a qEEG, with the more data points from more electrodes will show serious abnormalities. After my injury I had a normal EEG at the request of my regular neurologist, then, with a different neurologist, I had a very abnormal qEEG. The new neurologist was shocked by the magnitude of dysfunction.

Unless the qEEG is going to be used to direct neuro-feedback, very little therapeutic benefit will come from a qEEG.

It can help confirm symptoms. This can be a lifesaver as it helps the patient and family understand the symptoms are real and not imagined or psychosomatic.

In my case, it confirmed my auditory processing dysfunctions. In fact, the doctor was amazed that I functioned as well as I do with the magnitude of auditory dysfunction. It also validated the slowed processing, especially executive processing, that was diagnosed by the neuro-psychological assessment. I have had it done 4 times over six years. The similarity of all four further validates the symptoms and suggests that they are stable and fixed. At first impression, my neuro suggested that my damage was beyond recovery. Six years later, it appears he was right. He attributes my non-recovery to my age (46 at last injury) and my many previous injuries that had cumulatively used up the rewiring capability (plasticity) of my brain.

I don't want to rain on your parade. Danielle is still young with lots of potential for improvement. This is the toughest area of brain injury since the damage is likely diffuse throughout the brain. Focal injury is often more treatable as the brain can wire around the damage. With diffuse injury, the brain has a hard time finding strong pathways around the many weak pathways. Focal injury usually has some completely or almost completely severed pathways, so the brain abandons them.

The localized seizure activity sounds like there may be some focal injury that is treatable. If it combines with diffuse injury, Danielle needs to be holistic in her efforts to get her brain stronger. Maybe then, her brain can work around the damaged focal area.

Hope this helps. Give her a hug from me.

[Linda (Mom) in CT]

Thanks - is the cap generally comfortable? Have you had it?

My daughter just did the 48 hr. EEG her third EEG and she hates the discomfort and the glue and the gauze that takes several washings to get it out.

Linda

It's a lot less invasive than that. They have different sizes of caps so it fits comfortably on her head. It also only lasts on average for about 30-60 minutes.

Btw, I'm not sure where you are located, but Dr. Jonathan Walker out of Texas is a leading expert in brain rehabilitation and does QEEG's. Here is a link to his website: http://www.neurotherapydallas.com/index.php. If nothing else, he could probably answer your questions and point you in the right direction.

[Mark in Idaho]

I have had five EEG/qEEG's in the past 8 years. They have all been done with the cap. Back in 1970, they used electrodes that clipped to the skin with little spikes like those used to secure an Ace bandage.

I found that it is very helpful to shampoo your hair just before the test. Then, they can get the electrodes to make electrical contact easier. Use a shampoo that does not have a conditioner in it. Conditioning shampoo will likely add oil to your skin. The oil makes the electrical contact more difficult.

My qEEG's each lasted about an hour. EEG's done to test for seizures can last for hours, especially if they include a long sleep period.

The goo in the hair sounds familiar. It takes a good shampoo to get it all out.

The new MEG system sounds like it may promise a more pleasant experience.

[Linda (Mom) in CT]

Marc,

I didn't follow what is the new MEG?

And the qEEG is it uncomfortable with glue and such or just a cap with electrodes they put on your head?

Linda

[Mark in Idaho]

MEG is MagnetoEncephaloGraphy. It is a new technology that measures the electromagnetic energy of minute areas of the brain. It can be used to pinpoint areas of damage.

You will likely have a difficult time finding a clinic that uses it. It is more a research system at present. It is much less annoying than the qEEG or EEG.

Danielle's reaction to the discomfort of the EEG cap and goop may indicate a low threshold of stress/discomfort. Maybe the duration was a bit much for her. I did not find the cap to be overly uncomfortable.

A MEG system is much shorter duration in my understanding. It is more like a CT or MRI. See this web site:
http://www.nmr.mgh.harvard.edu/lrrl/megeeg.html
This MEG appears to be combined with an EEG with cap.

Here is a more complex explanation of MEG:
http://www.nmr.mgh.harvard.edu/marti...ologiesMEG.php

It sounds like a very interesting upcoming technology. As it become more common and some of the functional problems are resolved, it could answer many questions about focal abnormalities in the brain.