Brain imaging and analysis continues to evolve and provide us with more information upon which to base our clinical decisions. Brodmann mapped the cortex according to types of neurons and their density in different cortical layers. The areas he numbered (1 to 52 in each hemisphere) followed the variations in the cellular architectures he observed. The Brodmann area information has been employed for more than a century. Recently the SKIL database has provided the capability to subject the raw EEG to an analysis that employs the Brodmann areas as the focus of inquiry. Following is a QEEG analysis of a client in which the Brodmann analysis was the major factor in locating the abnormalities.
The client is a 65 year-old female who was referred by her physician. She evidenced no cognitive or gross motor abnormalities upon presentation. The client is currently in severe, unremitting sciatic pain which she reports to be worse in the right leg. She has a history of failed back syndrome and back surgery. The client’s family history includes maternal arthritis and fibromyalgia. Her three brothers also have back problems. At 17 years old, the client was in a car accident in which she experienced whiplash and possible rotational injuries. The client is an accomplished dancer, attorney, and film producer. She has consulted many physicians regarding her treatment and is considering the implantation of a morphine pump. The client is currently taking the following medications: Oxycontin, Dilaudid, Zanoflex, Neurontin and Keppra.
It is important to point out at the outset that the various medications (5) prescribed and used by this client have clearly altered the EEG and made interpretation of findings a true challenge. However, reliance on multiple recordings across a series of functional states, together with a battery of varied and unique quantitative measurement tools, made it possible to identify valid and reliable disturbances in her Central Nervous System.
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