A Video Electroencephalography (VEEG) is a specialized neurological test that provides a comprehensive look at brain activity alongside physical behavior. This procedure is a significant diagnostic tool, offering much more information than a standard electroencephalogram (EEG) alone. The purpose of this extended monitoring is to capture and analyze transient neurological events that may be difficult to diagnose in a brief office visit.
What VEEG Measures and Why It Is Used
VEEG monitoring measures the electrical activity of the brain (brainwaves) while simultaneously recording the patient’s physical actions via continuous video. The fundamental goal is to correlate abnormal electrical discharges within the brain with any visible physical symptoms or “spells” the patient experiences. This combination allows neurologists to determine whether an event is caused by abnormal brain activity, such as a seizure, or if it has a non-neurological origin.
The test is valuable for localizing the source of abnormal brain activity, which is often required for specialized treatment planning. By extending the monitoring period, VEEG significantly increases the chance of capturing infrequent or subtle events that a short, routine EEG would likely miss. This detailed observation helps confirm a diagnosis, classify the specific type of event, or rule out neurological causes for unexplained episodes. The recorded audio also captures sounds a patient might make during an event, aiding the analysis.
Preparing for and Undergoing the VEEG Procedure
Preparation for VEEG focuses on ensuring the best possible quality of the electrical signal recording. Patients are instructed to wash their hair the night before or the morning of the procedure using only shampoo and water. It is important to avoid hair products, such as conditioners, gels, or sprays, as these can interfere with the adherence of the electrodes and the electrical conductivity. Your physician may also temporarily adjust or discontinue certain medications, especially anti-seizure drugs, to increase the likelihood of capturing a typical event during the monitoring period.
The procedure begins with an EEG technologist applying multiple small metal discs, called electrodes, to the patient’s scalp. A mild, conductive paste or adhesive, such as collodion, is used to ensure the electrodes have secure contact and remain in place for the duration of the monitoring. This application process is painless and generally takes between one to two hours to complete. Once the electrodes are secured, they are connected by thin wires to a recording system that transmits the continuous brainwave data.
The patient is then situated in a room with continuous video and audio recording equipment. Patients are advised to wear clothing that buttons or zips up the front, avoiding items that must be pulled over the head, to prevent dislodging the wires. Throughout the monitoring, patients must remain within the camera’s view so that any physical behavior can be precisely correlated with the corresponding brain activity data.
The Logistics of Extended Monitoring
VEEG monitoring is often a long-term study, typically lasting between 24 hours and up to seven days, depending on event frequency. This extended duration is necessary to gather sufficient data, especially for patients whose events are infrequent or occur during sleep. The monitoring usually takes place in a specialized hospital Epilepsy Monitoring Unit (EMU), which is equipped with trained staff for continuous observation and safety.
Safety protocols are a high priority during the stay, including padded bed rails and staff supervision, particularly when the patient is out of bed. In some cases, physicians may use controlled methods to try and trigger an event, such as encouraging sleep deprivation or reducing anti-seizure medication, but this is done under close medical supervision. Alternatively, in-home or ambulatory VEEG monitoring is an option for certain patients, offering the comfort of a natural environment while recording high-quality diagnostic data.
Interpreting VEEG Findings
Neurologists review the VEEG data by analyzing the continuous brainwave recording alongside the synchronized video footage. They look for specific electrical patterns, such as sharp waves or spikes, and note their exact timing relative to any visible behaviors the patient exhibits. This dual analysis provides VEEG its diagnostic power, allowing the medical team to pinpoint the focus of the abnormal electrical activity and classify the event. The video elements help determine the patient’s level of consciousness and describe the event’s progression.
The findings help the physician confirm whether the spells are true epileptic seizures, classify the seizure type, or rule out a neurological cause, suggesting a non-epileptic event. A final report is generated, which interprets the extracted EEG features within the context of the patient’s clinical history. The results then guide the next steps, which may involve follow-up consultations to adjust medication, discuss surgical options, or develop a long-term treatment plan.