J Neuropsychiatry Clin Neurosci 1991; 3:321-329
Copyright © 1991 by American Neuropsychiatric Association
Limbic system dysrhythmia: a diagnostic electroencephalogram procedure utilizing procaine activation
RS Ryback and EA Gardner
Associated Mental Health Professionals, College Park, Maryland.
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.
