EEG Metabolic Grand Rounds
Dr. Pierce is board certified in Chiropractic Neurology and QEEG and serves both boards; he is on the Exam committee of the American Chiropractic Neurology Board, and a registered mentor for the IQCB. He was past professor of clinical neurology and molecular neurochemistry for 2 institutions and trained many interns.
The purpose of EEG Metabolic Grand Round is to break through poor responding cases and illuminate mechanisms that may contribute to the confounding of DSM diagnosis and treatment due to the many forms of organic brain dysfunction. Some of the scope of practice may be outside certain members, but we an educational group only and are only making suggestions to explore, not a diagnosis or a formal second opinion. Such classed are for entertainment and educational purposes only and cannot be held to a medical standard as virtual learning. There can be no medical records kept or acceptance of doctor-patient relationship. The actual patient is not present as we review and discuss their records frankly and prioritize and triage the potential assessment and treatments as an educational exercise. This exercise is incredibly valuable to the practitioner and their patient as many minds contribute to synthesis, and the learning opportunity through real experience is priceless. Everyone contributes and the facilitator guides the discussion in a typically Socratic teaching style, with some lecture interspersed and reference to sources for further study and new concepts. Today services like Rupa aggregate lab services for mental health practitioners, and cover risk by offering an MD to read the labs for pathology for an extra $10 fee so the therapist is not held to a medical standard. We believe there is a cross disciplinary need for root cause analysis and a wider scope in cases of resistant response in mental health, without simply resorting to polypharmacy, or a series of trial and error with medications.
Like all grand rounds, we go through case details, lab reports especially and seek indicators of neurochemical dysfunction.
We begin with symptom reporting, history and chief complaint, and look at EEG and ERP if available, and history of counselling, neurofeedback or neuromodulation progress.
Then we move on to labs. We review past lab tests starting with standard blood tests, moving on to specialty tests, urine, saliva, hair, stool tests, and specialty panels for issues such as black mold, glyphosate, herbicide-pesticide-VOC toxicities, heavy metal burden, thyroid, lipids, hormone panels and more. The best is to have actual copies of lab reports with dates and normal ranges printed on them and screen shared, ideally deidentified. We can talk conceptually about cases, questions and mechanisms, but the best learning comes from reading lab tests and imaging together.
When required we explore imaging options such as abdominal ultrasound, x-ray, CT, MRI, SPECT, and other special imaging studies that affect metabolism, pathology and organic brain dysfunction.
We synthesize 2 things from all this for each case-next steps in assessment, and options for treatment. We hope to illuminate the root causes and mechanisms of the symptom or syndrome.
Perhaps the most important is the follow up aspect. Often weeks or months later we revisit the same case for updates and follow up news and learn about what worked well and what went poorly. This is the most effective feedback learning for clinicians possible, and creates strong, confident providers.
Students are always free to attend and contribute. Practitioners are encouraged to present their own cases an family members as well so that the group becomes healthy from within and through personal experience.
Options are given without dogma, although apparent rules of physiology are offered, and orthodox medical standard of care may be responsibly challenged. Learners have access to recordings that we scrub of identifying information.
We welcome suggestions and we prepare a shared file of resources for therapists and for them to handout to their clients if they like too. We encourage everyone contribute interesting things to these common shared files.
Questions are welcome.
The group will be meeting fortnightly.
The schedule tba