Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance
CPT4 code
Name of the Procedure:
Video Electroencephalogram (VEEG) with review of data and technical description by EEG technologist, 2-12 hours, with intermittent monitoring and maintenance.
Summary
A Video Electroencephalogram (VEEG) is a diagnostic test that records electrical activity in the brain along with video monitoring to capture and correlate physical symptoms with brainwave patterns. This procedure is conducted over a span of 2-12 hours and includes periods of intermittent monitoring and maintenance by an EEG technologist.
Purpose
VEEG is used to diagnose and evaluate conditions related to abnormal brain activity, such as epilepsy and other seizure disorders. The procedure helps in identifying the nature, location, and possible causes of seizures or other brain dysfunctions, leading to better-targeted treatments.
Indications
- Unexplained seizures or epilepsy
- Differentiation between epileptic and non-epileptic seizures
- Monitoring known seizure disorders
- Assessment of brain function in various neurological conditions
Preparation
- Patients might be asked to stay awake the night before the test to increase the likelihood of recording abnormal brain activity.
- Instructions may include continuing regular medications unless otherwise directed by a healthcare provider.
- Hair should be clean and free of oils, sprays, or gels.
- Sometimes fasting is required, but this varies per individual case.
Procedure Description
- The patient arrives at the clinical setting where a trained EEG technologist explains the process.
- Adhesive electrodes are applied to the patient’s scalp following the international 10-20 system.
- A continuous video monitoring system is set up to record the patient’s actions and behaviors.
- The EEG machine records brainwave activity for 2-12 hours, with intermittent monitoring and periodic adjustments by the EEG technologist.
- The video and EEG data are synchronized, allowing for correlation between physical symptoms and brain activities.
- Periodic challenges, such as hyperventilation or photic stimulation, may be performed to provoke and capture abnormal brain activity.
- The data is reviewed and interpreted to form a comprehensive report.
Duration
The procedure typically takes between 2 to 12 hours.
Setting
VEEG is usually conducted in a hospital, specialized epilepsy monitoring unit, or outpatient clinic equipped with the necessary recording and monitoring equipment.
Personnel
- EEG technologists who set up and monitor the equipment.
- Neurologists or epileptologists who review and interpret the data.
- Nurses may assist in patient care and comfort.
Risks and Complications
- Skin irritation or itching from the electrode adhesive.
- Minor risk of seizure induction during the test due to provocation techniques like flashing lights or hyperventilation.
- Rarely, prolonged monitoring could cause fatigue or discomfort.
Benefits
- Accurate diagnosis of seizures or other neurological conditions.
- Improved understanding of the type and source of seizures.
- Better-informed treatment plans, target interventions, and management strategies.
Recovery
- Patients can usually resume normal activities immediately after the procedure.
- Any specific post-procedure instructions will be provided by the healthcare providers.
- Follow-up appointments may be required to discuss the results and next steps.
Alternatives
- Routine EEG without video monitoring, although this may not capture the correlation between physical symptoms and brain activity.
- Magnetoencephalography (MEG), though it is less commonly available and more expensive.
- Imaging studies, like MRI or CT scans, though these do not provide functional brain activity data.
Patient Experience
- The procedure is generally painless and non-invasive.
- Patients may feel slight discomfort from the electrodes or prolonged immobility.
- Technologists and medical staff will provide comfort measures and ensure a timely break if necessary.
- Relaxation techniques may be employed to maintain comfort during the prolonged recording period.