# Why I recommend the EEG as a starting point



## forestx5 (Aug 29, 2008)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764488/

The EEG or electroencephalogram, can help establish the origin of dissociative symptoms, (unless I read

this abstract wrongly.)


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## 35467 (Dec 31, 2010)

These are all pre-surgical epileptic patients. So, an EEG and other parameters for a epileptic diagnosis was preformed and they was to have the area for the origins of the epilepsy removed. In it is in those examinations that the locations are found with using various scanners. The mention PET and SPECT scanners. It in a general problem prior to neurosurgery in epilepsy that the locations are very difficult to find. Some are called "MRI-negative" as the locations will not show up on a MRI scan. So, other scanners are used or combination or scanners. The text also mentions intercranial EEG in 8 of the patients. So, they have opened a part of the cranium to with very sensitive location on the brain tissue to make a more precise location of the epileptic area that have to be removed by surgery. So, is not the EEG that tells anything about the locations only if it's is epilepsy or not. The location are found with several other examinations. Because depersonalization is a condition "softer" than a neurological condition it is more complicated to find locations. It epilepsy it will be one location while in depersonalization it will likely be several locations within some networks.

Most neurological patients have in most cases either depersonalization or derealisation. Not both symptoms at the same time. The neurological patients locations for the origins of the symptoms have been used in depersonalization research for 70.years. Angular gyrus have been a suspected location in many decades because neurological patients showing neglect symptoms often had their problem around this area. It is rTMS location in depersonalization.

If the outset of depersonalization came without panic and stressor and it more fluctuating in nature a EEG might relevant to rule out a neurological condition but these cases are rare.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> These are all pre-surgical epileptic patients. So, an EEG and other parameters for a epileptic diagnosis was preformed and they was to have the area for the origins of the epilepsy removed. In it is in those examinations that the locations are found with using various scanners. The mention PET and SPECT scanners. It in a general problem prior to neurosurgery in epilepsy that the locations are very difficult to find. Some are called "MRI-negative" as the locations will not show up on a MRI scan. So, other scanners are used or combination or scanners. The text also mentions intercranial EEG in 8 of the patients. So, they have opened a part of the cranium to with very sensitive location on the brain tissue to make a more precise location of the epileptic area that have to be removed by surgery. So, is not the EEG that tells anything about the locations only if it's is epilepsy or not. The location are found with several other examinations. Because depersonalization is a condition "softer" than a neurological condition it is more complicated to find locations. It epilepsy it will be one location while in depersonalization it will likely be several locations within some networks.
> 
> Most neurological patients have in most cases either depersonalization or derealisation. Not both symptoms at the same time. The neurological patients locations for the origins of the symptoms have been used in depersonalization research for 70.years. Angular gyrus have been a suspected location in many decades because neurological patients showing neglect symptoms often had their problem around this area. It is rTMS location in depersonalization.
> 
> If the outset of depersonalization came without panic and stressor and it more fluctuating in nature a EEG might relevant to rule out a neurological condition but these cases are rare.


hey mg

i have a question

if i had have an onset from dp 2011 (drug induced) and i recovered once and later (beginning 2020) i relapsed, is my onset being 2011 or 2020?

and im further seeking for a provider who uses ocd coil from magventure and neuronavigation. if i will find one, i will report you.


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## 35467 (Dec 31, 2010)

It is very unlikely that you will find one now. Neuronavigation is used by very few as it is too costly and a deep coil is not approved in Europe yet. An Eastern European provider is what is i am looking for. The providers in Poland all uses Magtrim but Magventure should have got a representation in Poland this year. So, I expect it to come when COVID-19 is over. I think it is very unlikely that some will try to open such a place for treatment with the restrictions in place due to COVID.So, some time after COVID-19 is resolved.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> It is very unlikely that you will find one now. Neuronavigation is used by very few as it is too costly and a deep coil is not approved in Europe yet. An Eastern European provider is what is i am looking for. The providers in Poland all uses Magtrim but Magventure should have got a representation in Poland this year. So, I expect it to come when COVID-19 is over. I think it is very unlikely that some will try to open such a place for treatment with the restrictions in place due to COVID.So, some time after COVID-19 is resolved.


i just had have a telephonate with someone from magventure. in the research clinic in munich they have that coil from magventure, and also deep tms from brainsway and neuronavigation as well. fortunately i live in germany. i just have to wait 6 months for the first appointment.

but what you think about my other question?


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## leminaseri (Jul 1, 2020)

they dont treat people with dp anymore because they had almost have no success in the past. although they have a full equipment.


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## 35467 (Dec 31, 2010)

So, i have a principle on my activity on this site. I never reply to the same question that I have replied to before by the same person. Many have a tendency of obsessive ruminations about symptoms and posts endlessly about them again and again. I will never go waste my time on such obsessions. I have replied to your question before some months ago.

you are calling it a research facility in Munich and there have been a short case report from Munich last year with 4.patients with depersonalization trying a combination of rTMS with cognitive therapy. Two of them at the right VLPFC and two at the right TPJ. This is a replication of rTMS trails tried with normal coil. So, as you likely can only stimulate 30% of the right VLPFC and likely 60-70% of it with a deep coil, they have likely used a normal coil when they write it is replication of prior trails. They have not used a deep coil

i am not surprised that they have had a poor response as the locations might not be correct. A recent publication talks about a combination of fMRI and rTMS to find more about where the emotional regulation starts in depersonalization. So, studies including the depersonalization research units found that the anterior cingulate and the dorsomedial prefrontal was active in depersonalization and that is very OCD like location. You need a deep coil to do that. I have never read about this location tried in depersonalization. I hope that the French angular gyrus trail might go into some speculation about locations and networks for emotional regulation in depersonalization. The locations that you can stimulate with a normal rTMS coil have been tried by many and therefor it is likely to suspect that deeper location found active in depersonalization most play and central role.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> So, i have a principle on my activity on this site. I never reply to the same question that I have replied to before by the same person. Many have a tendency of obsessive ruminations about symptoms and posts endlessly about them again and again. I will never go waste my time on such obsessions. I have replied to your question before some months ago.
> 
> you are calling it a research facility in Munich and there have been a short case report from Munich last year with 4.patients with depersonalization trying a combination of rTMS with cognitive therapy. Two of them at the right VLPFC and two at the right TPJ. This is a replication of rTMS trails tried with normal coil. So, as you likely can only stimulate 30% of the right VLPFC and likely 60-70% of it with a deep coil, they have likely used a normal coil when they write it is replication of prior trails. They have not used a deep coil
> 
> i am not surprised that they have had a poor response as the locations might not be correct. A recent publication talks about a combination of fMRI and rTMS to find more about where the emotional regulation starts in depersonalization. So, studies including the depersonalization research units found that the anterior cingulate and the dorsomedial prefrontal was active in depersonalization and that is very OCD like location. You need a deep coil to do that. I have never read about this location tried in depersonalization. I hope that the French angular gyrus trail might go into some speculation about locations and networks for emotional regulation in depersonalization. The locations that you can stimulate with a normal rTMS coil have been tried by many and therefor it is likely to suspect that deeper location found active in depersonalization most play and central role.


no man youre wrong. you didnt gave me an answer for that question, thats the reason why im asking multiple times.


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## 35467 (Dec 31, 2010)

Likely a similar dynamic like in recurrent depression so it will be in 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911177/


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> Likely a similar dynamic like in recurrent depression so it will be in 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911177/


so the onset is not recent and rtms will most likely not work.


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