Look At The Brain To Avoid Missed Diagnoses and Treatment Failures

Recently I attended a medical conference in Las Vegas. This annual event is organized by the American Academy for Anti Aging Medicine and provides fascinating topics, gives information about the newest diagnostic methods and presents treatment options that reach beyond the borders of conventional medicine. One morning lecture which took place on December 14, 2012 and was given by Dr. Daniel Amen was probably an unforgettable session for the large audience which filled the main auditorium. Dr. Amen is a psychiatrist, and he explained in detail the importance of a correct diagnosis for psychiatric problems. One diagnostic tool is the SPECT scan. It is not just some sophisticated scanning method that shows interesting images of the brain, but it gives detailed information, which area of the brain is affected. As a result a trained specialist will  be able to classify, which treatment option would yield the best result to help the patient who may have a form of depression or other psychiatric disorder. A pill such as Prozac is not the miracle cure for all forms of depression! Through detailed scan information treatment failures can be avoided, which could mean a difference of a patient being able to lead a healthy and productive life as opposed to a patient who could not be helped and who is institutionalized, has hurt others, killed in a rage or has taken his own life.

Look At The Brain To Avoid Missed Diagnoses and Treatment Failures

Look At The Brain To Avoid Missed Diagnoses and Treatment Failures

The SPECT scan depicted here is from a patient who suffered from Lyme disease, but his treating physicians at first did not believe him. It was only after the abnormal SPECT scan on the left that further more sophisticated tests did prove Lyme disease was present and extensive antibiotic treatment cured the lad (normal SPECT scan on the right).

Mental problems can present in frightening ways, as the lecturer presented the case of a young boy who showed behavioral changes that were terrifying to his family. Previously an easy going lad, he turned into a challenge for his family and his teachers. He was bounced from specialist to specialist, and various diagnoses were mentioned, ranging from the statement that he was manipulative and attention-seeking to assuming that he was hyperactive and had a learning disability. The term conduct disorder also came up for discussion. But nothing of that helped to improve the situation. The parents felt like they were losing their child that was on a downhill course and on a destructive path. Finally a SPECT scan did reveal a previously overlooked condition: the boy had a cyst on the frontal lobe of his brain. It looked like a trench that prevented the frontal brain to communicate with the rest of the brain.  He did need surgery in order to remove the enlarging cyst (pull down to see images), which was not an easy surgical procedure. However the scan result led to the identification of the problem, and this patient – in the meantime a young adult – is no longer troubled by psychiatric problems, but holds a job, has good interpersonal relationships and functions like any normal individual of his age group. Overlooked, undiagnosed and not properly treated mental disease robs people of their ability to lead full and productive lives. Patients with mental illness also represent a large number of the prison population.

The lecturer briefly stopped and mentioned that we may have heard of the tragic and unfathomable events in a Connecticut school where 20 children were shot and killed by a 20 year old young man (we all know this now as the Sandy Hook Elementary School shooting in Connecticut). A somber silence settled over the audience. As most of them had been attending conference lectures all morning, they had not heard about the school shooting and would see the shocking details on the news channels only  later that day. For a whole nation December 14, 2012 will be etched into memory as a day of horror, of evil, lives destroyed and hearts broken. For those who listened to the lecture it will be a permanent reminder that mental disorders need effective diagnoses and persistent treatment. Mental illness has been kept behind closed doors in the past, was a source of embarrassment and shame, and denial was common in order to keep a pleasant facade. The consequences can be a source of terrible suffering, which starts with the patient and his family, but as seen a few days ago it reaches into the community and beyond.

More information on mental illness:

Last updated Nov. 6, 2014

About Ray Schilling

Dr. Ray Schilling born in Tübingen, Germany and Graduated from Eberhard-Karls-University Medical School, Tuebingen in 1971. Once Post-doctoral cancer research position holder at the Ontario Cancer Institute in Toronto, is now a member of the American Academy of Anti-Aging Medicine (A4M).