PREPARING FOR A VIDEO AMBULATORY EEG
What is a Video Ambulatory EEG?
An electroencephalogram (EEG) is a test to detect problems in the electrical activity of the brain. Video Ambulatory EEG is considered to be the Gold Standard for EEG testing. This allows the doctor to see any kind of events that you may have while you are conducting some of your normal daily activities and during sleep. The ambulatory EEG device will be worn for a specific amount of time that your doctor believes will give him/her the best chance to find what they are looking for, usually 72 hours in most cases. Ambulatory EEG monitoring enables your doctor to observe your EEG over a prolonged period of time, and ambulatory monitoring can help diagnose your type (seizure, spells, etc.) and provides important information regarding the best treatment for your seizures.
Why the Test is Performed?
EEG is used to help diagnose the presence and type of seizure disorders, to look for causes of confusion or periods of unconsciousness, and to evaluate head injuries, tumors, infections, degenerative diseases, and metabolic disturbances that affect the brain.
Will my family members or spouse be videotaped?
If one of your family members happens to walk in front of the video camera, they will be on the video briefly. But the physician is only interested in seeing you, the patient, on video when there are clinically significant events occurring. So, even if your family member were to walk in front of the cameras, it would be very unlikely that the physician would ever see that particular portion of the video. The video recording is continuous, but it will be analyzed and edited by powerful software so that only portions that require the physician’s attention will be viewed.
What will be setup in my home, and what areas will be recorded on the camera?
At night it will be positioned in the bedroom and aimed at the side of the bed where you will be sleeping. During the day the camera should be positioned in the living room, or another comparable area you designate, where you spend a significant amount of time. The camera view is limited to a chair or couch where you will be the majority of the time you are on camera, or undergoing monitoring. The camera should only be used in your home, and it is not meant to be used in any other location.
What will happen when I am set up for monitoring?
Placement of the EEG wires for monitoring You will have all the same electrodes that you had for your routine EEG except this time they will be held on using special tape that is made specifically for this type of medical procedure. EEG wires will be attached to your head with special glue so that the electrodes will stay attached for several days. Sometimes, the electrodes can cause some itching to occur and you can take medication to help the itching. Do not scratch your head with the electrodes in place. Benadryl 25 mg to 50 mg can be used for itching. This can be obtained over the counter at your local pharmacy.
Please do not eat potato chips or other snack foods or chew gum, since this will interfere with the EEG – it generates a lot of “noise” on the graph which makes it impossible to detect anything else.
You should wear comfortable clothing while your ambulatory EEG is being performed. You will want to wear a shirt that opens in the front so that you will be able to undress easily at night. For example, sweat pants and a loose fitting top with buttons down the front are suggested. Tight fitting sleeves and pull over tops will not be suitable. Do not attempt to pull a shirt or other clothing over your head during the ambulatory EEG. The electrodes may become dislodged, and the quality of the recording will be affected.
What do I need to do before my test?
- Assemble enough comfortable, appropriate clothes to wear. Most patients wear street clothes or a sweat suit during the day and warm pajamas and socks at night. Remember that the tops should button and be loose fitting.
- Bathe and wash your hair well.Do not leave any hair products in your hair and remove any braids or hair extensions. This will facilitate comfortable placement of the electrodes.
What is Ambulatory EEG Monitoring?
EEG is the abbreviation for electroencephalography. The electroencephalograph is a machine that translates the electrical activity of the brain into a series of wavy lines (a graph) on a computer called the EEG record.
An EEG measures the electrical activity of the brain, sometimes referred to as brain waves.This test is performed to see how the different parts of your brain function. It records a graph of your brain waves.
Digital analysis is a procedure that can give additional information about any problems that may be found.
Analysis and examination of the data obtained allows your doctor to see one of the many ways that your brain functions. EEG is not a treatment of any kind. No electricity is transferred to your brain. The EEG only detects activity in the brain.
If you have a seizure during the test, you should behave as you normally would during a spell / seizure. Family and friends should follow your usual spell / seizure first aid or emergency procedures.
It can tell us what may be causing your episodes and help with deciding the best treatment for you.
The doctor can see abnormal activity as well as sleep stages during your EEG.
The ambulatory EEG is a very expensive (~$20,000) piece of equipment that allows us to monitor a 48 – 72 hour period (or more) of brain waves – you may not be able to do the majority of your normal daily activities during this time. Do not get it wet. Do not allow the camera or the box to get hit or banged against other objects. Do not attempt to adjust anything on the camera, or the device, and do not adjust the wires. You will be held responsible for any damages.
At the end of the time period (48 – 72) you will return to the EEG clinic to have the electrodes removed and then the information gathered or collected will be downloaded to the computer for analysis.
How does an Ambulatory EEG work?
Small, non-invasive metal cups called electrodes (usually 16 to 32 in number) are pasted on the scalp, after careful measurement by a trained technologist. The tape and gauze wrap is to keep the electrodes firmly in place. If the electrodes are moved, then the quality of the recording will be poor. The electrodes pick up very small changes in brain electrical activity. The activity is amplified and recorded on the computer. It is then translated into a complicated graph. During this procedure, the EEG is recorded for a prolonged period, allowing you to have a comprehensive EEG at home. You will need to keep a diary with exact times to correlate behavior with events on the EEG. Do not forget to write in the journal or diary, and bring it with you when you return to the clinic. This helps to determine the cause of any seizures.
How will I get my results?
After the technologist completes your study the doctor will review the study and discuss it with you at your next visit. If there are issues regarding the EEG of immediate concern, the doctor will contact you for further testing or discuss the findings with you on the phone. Do not ask the EEG technologist to interpret or explain your results. The EEG technologist will contact the physician if your EEG shows something that may be of immediate concern.