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QEEG Guided Treatment of Coma/Minimal Consciousness

Serial QEEG studies and source localization (see above) have been used to evaluate cognitive processing in patients who are persistent vegetative state (PVS). QEEG abnormalities observed in these patients are considered to reflect imbalances in brain neurotransmitter availability. With the assumption that the brains of patients in PVS have been down-regulated as an inherent protective mechanism, decreasing responsiveness to external stimulation which further adds to the down-regulation, medications have been administered by the medical clinical team to block inhibitory neurotransmitters. After optimal blockade of inhibition has been achieved, as reflected in the QEEG features moving toward normal, further improvement is sought by administration of excitatory neurotransmitters. Patients are then placed on a individualized optimal medication regimen to balance excitatory and inhibitory influences. QEEG trajectories are constructed by regular serial evaluations of brain function and cognitive status probed by use of neurocognitive challenges. A number of patients considered hopeless in their conventional hospital stay, have been transferred to care under such a protocol in both acute and sub-acute settings, have been restored to a minimally conscious state (MCS) or better. [This work was supported in part by a grant to the International Brain Research Foundation from Mrs. G. Bohan.] A manuscript describing case studies using this approach is currently in review.

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