What is a Video EEG test?

A Video EEG test records your brainwaves on an EEG and a video of what is going on at the same time. The purpose is to be able to see what is happening when you have a seizure or event and compare the picture to what the EEG records at the same time. Sounds that occur during the testing are also recorded - this can pick up if a person talks or makes sounds during an event. By doing this, doctors reading the EEG can tell if the seizure or event was related to the electrical activity in the brain. If so, we'd call this an epilepsy seizure.  

  • Video-EEG is most helpful to determine if seizures with unusual features are actually epilepsy, to identify the type of seizures, and to pinpoint the region of the brain where seizures begin. Locating the region precisely is essential if epilepsy surgery is being considered.
  • Other names for Video EEG tests include: EEG telemetry, EEG monitoring, or Video EEG monitoring. Usually these terms mean the same thing. 

Where are Video EEG tests done?

Video EEG tests are usually done in a hospital setting where seizures can be monitored in a safe way.

  • Since seizures are unpredictable, they may not occur right when you want them to during EEG monitoring. When a person is hospitalized for the testing, seizure medications can be lowered to help provoke seizures so they can be recorded. 
  • The length of testing varies depending on how often a person usually has seizures, the type of seizures, and why the monitoring is being done. Testing may take a few days to a week or more. 

Video EEG tests can be done at home or in the outpatient setting, like an EEG lab.

  • In some EEG labs, a person may be monitored by EEG and video over a number of hours in one day. This may be good for people with seizure types that occur very frequently, happen at specific times of day or can be easily and safely triggered (for example by flashing lights). 
  • Some centers can send video equipment home with someone having ambulatory EEG monitoring. This testing may help record a person's activity and seizures during their routine daily activities and during sleep. This is hard to do if someone lives alone as someone is needed to help with the equipment and help the person during a seizure. 
  • Due to safety risks, seizure medications are generally not lowered for EEG testing done outside of a hospital setting. 

What happens during Video EEG tests? 

  • The EEG leads are placed on your head with a special paste called collodion, just like with ambulatory EEG testing. The head (and electrodes) are usually covered by a cap or gauze dressing. 
  • Usually, you are admitted to a room on the epilepsy monitoring unit where the EEG, audio and video recording can be done. 
  • The electrodes are connected to a wire or cord that is attached to a cassette. The cord may also be connected to a special EEG connection in the wall or to a nearby machine. Increasingly, wireless systems are being used in monitoring rooms. 
  • During the monitoring, the epilepsy doctors may lower your medicines to make seizures more likely to occur. Sometimes other things are done to trigger seizures, such as deprive you of sleep, use flashing lights or exercise. 
  • The goal of testing is usually to record your typical seizures or events and to keep you safe. Sometimes lowering medications may lead to more seizures than usual or you could have a bigger seizure or one that lasts longer than normal. Doctors and nurses may need to give you seizure medications that act quickly to stop long or repeated seizures if they occur during the testing. 

What is done to keep me (or my loved one) safe? 

When testing is done in the hospital, a number of safety steps will be taken. Monitoring units have different physical layouts that allow staff to watch you closely. Here are some examples of other safety strategies that may be used: 

  • You may not be allowed to get up and walk around on your own. What you can do will depend on a number of factors such as your seizure type, how often they occur, other safety risks and the environment. 
  • If medications are withdrawn, your activity will need to be monitored even more carefully. When out of bed, you may need a staff member with you. They may place a belt around your waist to keep you from falling if a seizure occurs while walking. 
  • You will be asked to sit on top of the bed, within camera view so good video recordings can be obtained. 
  • Sometimes during or after seizures, a person may try to get out of bed, run or pull at electrodes. This usually happens when a person is confused or not aware of what is going on. In these situations, your epilepsy team may recommend things like a seat belt restraint to keep you from climbing out of bed, mitts on your hands or other types of safety steps. 
  • Pads are put on the side rails of the bed to keep you from hurting yourself (in case arms or legs hit the side rails during a seizure). 
  • Oxygen, a suction machine, and other safety equipment is kept nearby, just in case it's needed during a long seizure. 

Other helpful tips

  • A lot of patients say it's boring, just sitting around the hospital day after day. So bring things to read or something else to keep you busy.
  • Bring clothes that button or zip up so you don't have to pull them over your head. Remember, the EEG equipment is on your head! 
  • Ask the staff about use of electronic equipment. Usually a cell phone, laptop or other device can be used but not while it is plugged in. This is done to avoid interfering with the EEG recordings and equipment. 
  • Ask the staff if someone should come with you. Many times it helps to have a family member friend or caregiver stay with you during the testing. They can help observe seizures that people who don't know you won't pick up easily. This is done most often for children, people with other disabilities that may not be able to stay alone in the hospital, or in other special circumstances. 
  • Space out visits from family and friends. It's often better to have people visit for few hours at a time throughout the day rather than many people at once. This way they can help break up the boredom and help observe for seizures. 
  • Make sure you tell your epilepsy team about all medications you take and other health problems you may have. This information may affect how the EEG testing and medicine changes are done and what other care needs you may have. 
  • Having Video EEG testing done in a hospital can be stressful. Make sure you tell the staff how you are feeling. Ask for help and ask questions! You may not get all the answers right away, but you'll have staff there to help you get through the testing in a safe and supportive way. 

 

 

Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 8/2013
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