Brain Region Localization

Brain Region Localization Form

 
 
  • The purpose of this questionnaire is to identify difficulties that you may be experiencing. Please answer every question, do not skip any questions. Follow the 0 to 4 key, and select which best fits for all of your answers.
  • 0 = I never have symptoms (0% of the time)
    1 = I rarely have symptoms (Less than 25% of the time)
    2 = I often have symptoms (Half of the time)
    3 = I frequently have symptoms (75% of the time)
    4 = I always have symptoms (100% of the time)
 

Frontal lobe Prefrontal, Dorsolateral and Orbitofrontal (Areas 9, 10, 11, and 12)

 

Frontal Lobe Precentral and Supplementary Motor Areas (Area 4 and 6)

 

Frontal Lobe Broca’s Motor Speech Area (Area 44 and 45)

 

Parietal Somatosensory Area and Parietal Superior Lobule (Areas 3,1,2 and 7)

 

Parietal Inferior Lobule (Area 39 and 40)

 

Temporal Lobe Auditory Cortex (Areas 41, 42)

 

Temporal Lobe Auditory Association Cortex (Area 22)

 

Medial Temporal lobe and Hippocampus

 

Occipital Lobe (Area, 17, 18, and 19)

 

Cerebellum - Spinocerebellum

 

Cerebellum - Cerebrocerebellum

 

Cerebellum - Vestibulocerebellum

 

Basal Ganglia Direct Pathway

 

Basal Ganglia Indirect Pathway

 

Autonomic Reduced Parasympathetic Activity

 

Autonomic Increased Sympathetic Activity

 
 
  • The purpose of this questionnaire is to identify difficulties that you may be experiencing. Please select yes or no.
 

Epileptiform Activity

 

Verification

 


Brain Centers Northwest