Limbic system dysrhythmia: a diagnostic electroencephalogram procedure utilizing procaine activation.
A diagnostic method is presented that makes it possible to distinguish patients who are most likely to show a positive response to treatment with anticonvulsant medication, thereby cutting across many DSM-III-R diagnoses. Patients are evaluated to determine whether they exhibit at least 4 of 12 groups of symptoms, and the local anesthetic procaine is used, along with an electroencephalogram (EEG) to evaluate for omega band activity (30-50 Hz) of at least 50 microvolts or approximately three times baseline values in the anterior temporal leads. This method was studied in 145 patients with varying diagnoses. Eighty-three percent of patients who were symptom- and procaine-positive responded to anticonvulsants. Specific application to patients with attention-deficit hyperactivity disorder, bipolar disorder, and panic disorder is made. This method may provide a basis for identifying subpopulations of anticonvulsant-responsive patients who often are considered treatment-resistant.
Ryback
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Associated Mental Health Professionals, College Park, Maryland.
Gardner
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EA
D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D002220:Carbamazepine / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D008032:Limbic System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D011343:Procaine; D013702:Temporal Lobe / Q000503:physiopathology
D002220:Carbamazepine; D011343:Procaine