Month: June 2011

Clinical Policy Bulletin: Quantitative EEG (Brain Mapping) from Aetna

Recently Released Clinical Policy Bulletin: Quantitative EEG (Brain Mapping) from Aetna

It is no surprise when insurance companies find ways to restrict what they will cover as a service for their clients, whether flood insurance liability insurance, or any other branch of this financial industry.  This is especially true for medical insurance companies, which are always finding reasons to restrict payments.

This decision restricts the payment for a qEEG to be an extension of the analysis of an EEG analysis, which makes the qEEG a medical procedure requiring licensure adequate to provide credentials to do a medical EEG interpretation. If further restricts the payments to applications that match the American Academy of Neurology position paper, which approves the technique in vascular cases, encephalopathies such as dementia cases, or for epilepsy, as well as longer term EEG monitoring, where quantitative analysis allows the selection of segments for review visually, assisting the electroencephalographer in eliminating long time segments from detailed analysis.

Specifically restricted from payment are these applications:

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Houston’s Tarnow Center offers solution for service members with PTSD

A friend of qEEGsupport.com ( Dr. Ron Swatzyna) was recently featured on a local news station in the Houston area.

HOUSTON – A Houston doctor is working on something that could help the many service members who return from the battle field suffering from post-traumatic-stress disorder.

By its own admission, The Veterans Administration has had little success treating people who are suffering from both traumatic brain injury and post traumatic stress disorder.

“They end up not having any cognitive strategies to manage the therapy, and they’ll either get out of therapy, or end their lives and that’s what’s happening,” said Dr. Ron Swatzyna, a psychotherapist, neuro-therapist, and biofeedback therapist for Houston’s Tarnow Center. “I’ve been working on this issue for about four years now.”

He said resetting the brain, lining it back up through stimulation, is the key.  And by mapping the brain, he believes he can tell when the patient is ready for therapy.

“Not at the beginning. If you push them too quick that’s a problem. If they are pushed into therapy too quick,” he said.

Swatzyna said the defense department and the VA both realize more research is needed, and if he can get funding, and cooperation from a group in the Texas Medical Center, he would like to open up a research center in Houston.

Vietnam veteran Billy Miller, who one of Swatzyna’s patients, is now helping him pull it off.

“Everyone I had been to before, all 25 doctors had never had military experience, they didn’t know what I was going through,” Miller said.

Swatzyna was a captain in the Air Force, and now many believe he is the best in the country at understanding veterans.

Army soldier Joel Brasier, who suffers from TBI and PTSD, believes Swatzyna is on the right track and is hoping research will lead to better, faster treatment.

“It’s an ongoing process, but eventually they are going to make a breakthrough and get us the help we need,” Brasier said.

Full story from khou.com

Current Research Regarding Blast Injuries in Veterans

This current research from the New England Journal of Medicine  – Detection of Blast-Related Traumatic Brain Injury in U.S. Military Personnel –  shows that Blast Injury is not at all like mild traumatic brain injury, since the mTBI does not involve white matter injuries. The research does show white matter changes during the medical evacuation, done in Germany using Diffusion Tensor Imaging, and also that the white matter changes continue to evolve. They also show that not all symptomatic blast injuries are seen with this technique.

No traditional structural neuroimaging was able to see this damage (like CT or routine MRI). The NY Times recently reported on soldiers injuries evading the M.R.I and CT Scans

The brain areas involved included the orbital surfaces of the frontal lobe and the temporal areas.

These results point to the need for a clinical diagnosis, not a reliance on any given technology to answer the clinical question.

The endocrine changes from supposed pituitary injury, and the presence of micro-emboli due to pressure wave impact on the thorax that are reported in blast injury is not at all dismissible with these findings.