Neurological Diagnosis and Treatment for Learning Disabilities

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Clinical Reference Guide:
What We Diagnose, How We Diagnose and Treatment Options

Attention-Deficit/Hyperactivity Disorder (ADHD) in Adults
Attention-Deficit/Hyperactivity Disorder (ADHD) in Children
Autism and Pervasive Developmental Disorder
Digital EEG and Evoked Potentials Assessment (DEEP)
Cognitive Guidance for High Achievers
Developmental Coordination Disorder
Learning Disabilities
Speech and Language Disorders
Physical Therapy

Why is it important to schedule a DEEP Assessment?

Bright Minds Institute offers a specialized EEG, called a DEEP, that captures more information than the standard EEG and allows the neurologist to thoroughly examine the subtleties and complexities of each individual. The purpose of neurological testing is to analyze the brain activity, how it is processing information, and how well the regions of the brain are communicating with each other.

DEEP is a Digital EEG and Evoked Potentials Assessment.

What is the difference between an EEG and DEEP?
An EEG is a 40 minute recording of brain activity. An EEG records one part. A DEEP records 7 parts: the EEG, Auditory (2x), Visual, Language, Spectral Analysis, and a comparative database of normal brain activity to help detect abnormalities.

The DEEP collects about twice as much information as a traditional EEG.

The result is a more accurate medical diagnosis, which in turn leads to more effective treatment.

How long does a DEEP take?
2 1/2 hours; longer in special circumstances

What is an EEG?
BMI image An EEG (electroencephalograph) is a neurological test that records continuous brain activity by attaching electrodes to the scalp. An EEG is an important test used worldwide to detect neurological abnormalities. It is primarily used to evaluate epilepsy, but may be recommended for other neurological problems such as headaches, behavioral disturbances, attention disorders, learning problems, language delay, developmental delay, and fainting spells. EEGs for children were first developed and used at Children's Hospital Boston.

Normally, doctors evaluate EEGs just by looking at the pattern of spikes and waves. However, a DEEP can provide a more detailed analysis in measuring brain waves. Because results may be graphically displayed on a schematic map of the head, the procedure is often called "mapping." In that sense, a DEEP should be viewed as an extension of (not a replacement for) traditional EEG. Patients undergoing a DEEP also have a traditional EEG taken, since the human eye is still superior to the computer in many aspects of brain signal analysis.

Who performs the DEEP?
EEG/DEEP Technician - highly trained member of the Bright Minds staff who conducts the test in a friendly, relaxed environment.

Where is it performed?
Bright Minds Institute's San Francisco main office

How does it work?
Electrical signs produced by the brain neurons are picked up by the electrodes and transmitted to a computer where they are analyzed according to their speed, height and location. The neurologist examines the EEG recording for abnormalities in the brain wave pattern.

What should you expect during set-up?
During the set-up your child can participate in activities that distract him/her while encouraging them to “sit still” such as reading, playing video games, talking to the staff, or watching a DVD. Set-up takes approximately 20 minutes and the EEG recording takes about 2 hours.

What can I expect during a DEEP?
BMI image
From the patient's perspective, the procedure is nearly identical to the EEG and EP. Electrodes are painlessly placed on scalp in order to measure electrical activity. For a DEEP, about 50 percent more electrodes are applied than for an EEG or EP. The extra electrodes help define in more detail the different parts of the brain, and they collect about twice as much data as a traditional EEG. This makes it possible to analyze the brain waves more comprehensively.

A patient has both resting (EEG) and stimulated (Evoked Potentials) brain activity monitored. The results are first read traditionally, by visual inspection. Afterward, computers can perform a variety of statistical analyses and compare a patient's results to a database of brain electrical activity.

Why would my doctor refer me for a DEEP Assessment?
Doctors often request a DEEP when they believe that a patient's brain function is abnormal but have trouble defining the cause. Typical referrals include patients of all ages (newborns to adults) with:
•  seizures
•  epilepsy (especially to better determine the epileptic source)
•  Landau-Kleffner Syndrome (when treatment is being considered)
•  unexplained developmental delay or intellectual decline (suspected dementia)
•  learning disability and/or attentional deficit disorder (to better determine the cause)
•  behavioral dysfunction or emotional illness (including unremitting headaches) when a biological cause is suspected
•  chronic fatigue syndrome
•  whenever a Standard EEG would be expected to show something but does not

Often, a DEEP helps doctors make a diagnosis and evaluation because it can analyze data more complexly than visual inspection can.

What are the advantages?
It is noninvasive.
It is highly informative.
It will help your child receive proper treatment.

What are evoked potentials?
Evoked potentials are procedures that record the brain's electrical response to visual, auditory, and sensory stimuli.

Spectral Analysis
BMI image
One of the most useful applications of a DEEP is spectral analysis and mapping, where the different levels of electrical activity in the brain are "mapped" using colored grey scaling on schematic maps of the head. To some, such brain electrical activity mapping (or simply "mapping") is taken as synonymous with DEEP. However, mapping is only a display technique and only the first step. The heart of DEEP lies with the underlying computerized analytic and statistical techniques.

BMI image The data collected from your child's testing is compared to a database of normal brain activity established at Harvard, Children's Hospital Boston, which helps our neurologist to determine the best treatment for the patient.

The patient should wash his/her hair the night before the test. Do not use hair conditioner, oils, or spray afterward.

After the test
Your child's hair may have some residual gel (for conductivity of the electrodes) left in it after the test and will most likely need to take a bath/shower that evening. It takes us 12 hours to turn around DEEP test results through digital analysis. Parents typically schedule a follow-up for the following day to meet with our neurologist to go over their child's DEEP results, findings and potential treatment program.


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