A Video EEG, or Video Electroencephalography, is a specialized diagnostic test that combines continuous video recording with electroencephalography (EEG) monitoring. This allows healthcare professionals to simultaneously observe a person’s physical behavior and record the electrical activity of their brain. The aim is to capture and analyze brain activity and corresponding physical movements, particularly during events that may be seizures. This combined data provides a comprehensive view for diagnosis and treatment planning.
Why a Video EEG is Performed
A Video EEG is performed to identify and characterize neurological conditions, especially those related to epilepsy and seizure disorders. It confirms an epilepsy diagnosis by capturing brain activity during seizure events, which is challenging with shorter, routine EEG recordings. The continuous monitoring helps classify different seizure types, such as focal or generalized seizures, by correlating brainwave patterns with observed physical manifestations.
The test also distinguishes epileptic seizures, which involve abnormal brain electrical activity, from non-epileptic events, like psychogenic non-epileptic seizures, which may resemble seizures but have different origins. For individuals considering epilepsy surgery, Video EEG helps pinpoint the exact area in the brain where seizures originate, which is important for successful surgical planning. It can also assess how well current medications are controlling seizures and inform adjustments to treatment plans.
The Video EEG Procedure
The Video EEG procedure involves placing small electrodes onto the scalp using a special paste or glue to ensure they remain in place for the duration of the monitoring. These electrodes detect and record the brain’s electrical signals. Simultaneously, a camera continuously records the patient’s movements, facial expressions, and any sounds they make. This monitoring typically extends over several days to increase the likelihood of capturing events.
The monitoring usually takes place in a hospital setting, often in a dedicated Epilepsy Monitoring Unit (EMU), where trained technologists and medical staff observe the patient around the clock. A split screen monitor may display both the EEG readings and the live video feed, allowing staff to correlate brain activity with observed behaviors. Patients may also have a button to press when they feel a seizure starting, alerting staff to a potential event.
Preparing for and Undergoing a Video EEG
Preparation for a Video EEG involves practical steps to ensure accurate readings and patient comfort. Patients are asked to wash their hair with only shampoo the night before or the morning of the test, avoiding conditioners, styling products, or oils, as these can interfere with electrode adhesion. Medication adjustments are usually directed by the physician; patients should continue prescribed medications unless instructed otherwise. Bringing comfortable clothing, such as button-down or zippered tops, is recommended as garments cannot be pulled over the head once electrodes are in place.
During the hospital stay, which can range from a few days to a week, patients can expect limited mobility due to attached wires and the need to remain within the camera’s view. Staff may encourage certain activities or safely provoke seizures by adjusting medications or using specific triggers, like flashing lights or sleep deprivation, to capture events. Patient safety is prioritized, with padded bed rails and immediate access to medical staff and equipment like oxygen. After monitoring, electrodes are carefully removed, and patients can resume normal activities and wash their hair.
Understanding the Results
After Video EEG monitoring, neurologists analyze the collected data, which includes hours or days of brainwave recordings and synchronized video footage. They review abnormal brainwave patterns, known as epileptiform discharges, and correlate them with the patient’s observed behaviors during events. This analysis helps identify the precise onset and spread of seizure activity within the brain.
The findings from the Video EEG offer diagnostic value. They help confirm diagnoses, classify the specific type of seizure disorder, and differentiate epileptic from non-epileptic events. The information gathered guides treatment decisions, including medication adjustments or, in some cases, determining suitability for epilepsy surgery. The neurologist will discuss these results with the patient and their family, providing a clearer understanding of the condition and outlining the next steps for management.