There are many different types of seizures which often are difficult to diagnose. Continuous video EEG monitoring is the most informative test for establishing the diagnosis of epilepsy and differentiating it from other forms of seizure activity. It is a non-invasive procedure that locates the region of the brain where seizures begin, making medical or surgical treatment more precisely targeted and successful.
The purpose of video EEG monitoring is to record brain wave activity between and during seizures, and to have a video picture of what happens during a typical seizure. The ability to precisely correlate the signs and symptoms on video recordings with the EEG changes provides the most important information for diagnosis and treatment.
Video EEG (electroencephalography) is performed at our epilepsy monitoring unit (EMU), a hospital-based setting where patients are observed around the clock. Because the purpose of the monitoring is to record seizure activity, anti-epileptic medication is often reduced or stopped in order to provoke a seizure. In the hospital setting, under the supervision of physicians, nurses and EEG technologists with specialized training in the care of patients with seizures, patients are carefully monitored and treated promptly if having a seizure.
Video EEGs may be performed when:
All physicians in the Comprehensive Epilepsy Center are specifically trained in the subspecialty of epilepsy. Our epilepsy monitoring unit, which includes eight dedicated video EEG units as well as other testing areas throughout Barnes-Jewish hospital, represents one of the largest video EEG monitoring capabilities in the nation.
What to Expect During Video EEG Monitoring
The eight-bed epilepsy monitoring unit at Barnes-Jewish Hospital is fully-equipped with the latest technology, and is staffed 24 hours a day with specialized nurses and technicians. The average hospital stay for a video EEG typically ranges from three to four days, but may last up to a week. Every effort is made to make the stay as pleasant as possible. Patients can bring books, video games or movies to watch and can have friends and family visit them during their stay.
Similar to a routine EEG, video EEG requires tiny electrodes to be pasted on the scalp. The electrodes are connected to a small box that is worn as a hip pack. This connects by a cable to the wall so that EEG activity can be continuously recorded. This and the need to stay within the video camera's range limit activity during the testing, although patients are able to move about the room.
While the EEG records electrical activity in the brain, a camera feeds a live video stream of the patient to the clinicians in the monitoring bay. Patients are recorded for the entire length of their stay, allowing neurologists to compare the patient’s physical activity with their brain activity.
Depending on the type of seizures, a patient may be asked to sleep or avoid sleep for parts of the study. Sometimes, flashing lights, hyperventilation (rapid breathing) or use of an exercise bike are helpful to cause a seizure during the study. Patients may need to have a friend or family member with them, especially if a lot of seizures are occurring.
In some cases, additional testing may be needed, including brain imaging studies such as PET, MRI or SPECT testing.
To make an appointment with a Washington University epileptologist, neurologist or neurosurgeon at Barnes-Jewish Hospital, call 855.925.0631.