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Neurology: Epilepsy - Adults Video EEG Monitoring

Continuous video EEG-monitoring is used to establish the diagnosis of epilepsy and differentiate it from other forms of seizure activity. The non-invasive procedure pinpoints the exact regions of the brain where the seizure originates so medical management or surgery may improve or stop the seizure activity. 

Up to 30% of people with seizures do not have epilepsy and therefore, their epilepsy medications are not necessary. This type of monitoring over several days time, brings to light other options for treatment.

The expense of the procedure is covered by most health insurance plans and Medicare.

PLEASE CALL (314) 362-7174 to schedule continuous Video EEG monitoring or for more information on this type of testing.

Video EEG is performed in a hospital setting, so that the person can be observed round the clock.

The purpose of the monitoring is to record seizure activity; therefore seizure medicine is often reduced or stopped in order to provoke a seizure. In the hospital setting, we can make sure the person is safe while having a seizure.

The Epilepsy Center uses its six-bed unit at Barnes-Jewish hospital to monitor seizure activity. The unit is fully equipped with the latest technology and a skilled staff who make the visit as pleasant as possible. The average hospital stay in the video EEG monitoring unit typically ranges from three to four days, but may last up to a week. The EEG monitoring units are staffed with specialized nursing and technical staff 24 hours a day. Every effort is made to make the stay as pleasant as possible. People can bring books, video games or movies to watch and can have friends and family visit them during their stay.

What is the Purpose of EEG Monitoring Evaluations?

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. Both of these components are important to identify the seizure type and to help in future treatment planning.

The EEG electrodes are placed on the scalp, similar to a routine EEG. The electrodes are connected to a small box that is worn as a hip pack. This connects by a cable to the wall in the room so that EEG activity can be continuously recorded. This and the need to stay on video camera limit activity during the testing.

Special imaging tests, such as magnetic imaging resonance (MRI), Positron Emission Tomography (PET), and single photon emission tomography (SPECT) can be done in conjunction with the video EEG monitoring to help pinpoint the areas of the brain causing the seizures. MRI can reveal structural brain abnormalities causing seizures. PET allows detection of brain areas with abnormal metabolism, likely areas for seizures to originate. SPECT is often done during the seizure itself, and is referred to as ictal SPECT.

About SPECT - Single Photon Emission Tomography

SPECT done during a seizure increases the ability to identify the exact location from which seizures start in the brain by using an injected radioisotope to track sometimes subtle changes in blood flow in the area. By combining that data with the EEG readings, physicians also can trace the extended blood flow patterns that identify seizure pathways. The isotope must be administered as soon as the seizure starts, so it must be done under inpatient conditions

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Copyright 2015 Washington University School of Medicine
Copyright 2015 Washington University School of Medicine