Practice Guideline: Use of Quantitative EEG for the Diagnosis of Mild Traumatic Brain Injury: Report of the Guideline Committee of the American Clinical Neurophysiology Society.

SUMMARY: Despite many decades of research, controversy regarding the utility of quantitative EEG (qEEG) for the accurate diagnosis of mild traumatic brain injury (mTBI) remains. This guideline is meant to assist clinicians by providing an expert review of the clinical usefulness of qEEG techniques for the diagnosis of mTBI. This guideline addresses the following primary aim: For patients with or without posttraumatic symptoms (abnormal cognition or behavior), does qEEG either at the time of injury or remote from the injury, as compared with current clinical diagnostic criteria, accurately identify those patients with mTBI (i.e., concussion)? Secondary aims included differentiating between mTBI and other diagnoses, detecting mTBI in the presence of central nervous system medications, and pertinence of statistical methods for measurements of qEEG components. It was found that for patients with or without symptoms of abnormal cognition or behavior, current evidence does not support the clinical use of qEEG either at the time of the injury or remote from the injury to diagnose mTBI (level U). In addition, the evidence does not support the use of qEEG to differentiate mTBI from other diagnoses or detect mTBI in the presence of central nervous system medications, and suitable statistical methods do not exist when using qEEG to identify patients with mTBI. Based upon the current literature review, qEEG remains an investigational tool for mTBI diagnosis (class III evidence).

Anti-NMDAR Encephalitis.

Anti-N-methyl-D-aspartate receptor encephalitis is a newly described disease process. Patients are generally young females who present with psychiatric symptoms and progress to have seizures, abnormal movements, and. autonomic instability. Diagnosis is made based on serum and cerebrospinal fluid results, However, a characteristic EEG pattern described as extreme delta brush has been associated with this disorder making it especially relevant to neurodiagnostic technologists in practice today. Our case presentations follow two patients through the course of their illness and recovery.