Our understanding of epilepsy has been greatly advanced by video-EEG monitoring, which allows prolonged simultaneous recording of the patient’s behavior and the EEG. Seeing EEG and video data at the same time permits precise correlation between seizure activity in the brain and the patient’s behavior during seizures.
Video-EEG recordings can be done on hospitalized inpatients or on outpatients, though the inpatient recording typically is of better quality as technologists are available to adjust electrodes and diminish outside activity that can interfere with the recording. As with ambulatory EEG, the electrodes used for video-EEG recording are also glued to the scalp with collodion, although in special situations, paste may be used.
Inpatient monitoring with close supervision allows the doctor to reduce and, in some cases, discontinue antiepileptic drugs safely. The medication reduction and possibly sleep deprivation, hyperventilation, exercise, or occasionally alcohol intake may be used to induce seizures. Video-EEG can be vital in the diagnosis of epilepsy and epileptic seizures. It allows the doctor to determine:
This last step is critical in assessing a patient for possible epilepsy surgery.
What to Expect
A patient who is going to have video-EEG monitoring should bring clothing to the hospital that can be buttoned, as sweaters and shirts to be pulled over the head can interfere with the EEG wires. The patient should also bring reading materials and other things (knitting, sewing, paperwork) to keep busy, as a prolonged hospital stay for monitoring can be boring.
At the NYU Health Care Center (HCC) where most video EEG monitoring takes place, we have an extensive library of books and DVDs for patients to enjoy. As of now, personal electronic devices are not allowed due to hospital policy, but access to a hospital based computer is sometimes available at the HCC. Patients should check with the scheduling staff for the most up to date information. Finally, patients should expect to be fairly immobile (either in the bed or a chair), as they should be on camera at all possible times and will only have a limited extension of cord that allows them to use the restroom in private.
Patients should expect to have an intravenous (IV) catheter inserted into one of the veins of their hand or arm. This is done to allow nurses to give IV medications in case the patient has a prolonged seizure or multiple smaller seizures. Also, IV access is necessary for SPECT imaging.