Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84
CPT4 code
Name of the Procedure:
Electroencephalogram (EEG), Continuous Recording with Physician Review, Analysis of Spike and Seizure Detection, Interpretation, and Summary Report (Complete Study: 60-84 Hours)
Summary
An Electroencephalogram (EEG) is a test that records electrical activity in the brain over a continuous period, ranging from 60 to 84 hours. This involves wearing a cap with electrodes attached to the scalp to detect and record brain wave patterns. A physician or qualified healthcare professional reviews the recorded events, analyzes for spikes and seizures, interprets the data, and provides a detailed summary report.
Purpose
The primary goal of this extended EEG study is to diagnose and monitor neurological conditions, primarily epilepsy and other seizure disorders. It helps in identifying abnormal brain activity, understanding the frequency and types of seizures, and planning appropriate treatment.
Indications
- Recurrent, unexplained seizures or spells.
- Suspected epilepsy or other seizure disorders.
- Monitoring treatment efficacy in patients with known seizure disorders.
- Unexplained episodes of unconsciousness or altered mental state.
- Assessing brain activity in critically ill patients.
Preparation
- Wash hair thoroughly the night before; avoid applying hair products.
- Continue taking prescribed medications unless instructed otherwise.
- Inform the healthcare provider about all medications and supplements being taken.
- Some facilities may ask patients to maintain a sleep diary or reduce sleep the night before to increase the likelihood of recording abnormal activity.
Procedure Description
- Electrode Placement: The patient wears a cap fitted with multiple electrodes.
- Continuous Recording: Over the course of 60-84 hours, the EEG device continuously records brain activity.
- Event Annotation: The patient and caregivers may be instructed to note any unusual events or symptoms during the recording period.
- Data Review and Analysis: A physician will analyze the recorded data for spikes, seizures, and other abnormal brain activities.
- Interpretation and Report: A detailed interpretation is done, and a comprehensive report is provided summarizing the findings.
No sedation or anesthesia is typically required for this non-invasive procedure.
Duration
The recording lasts greater than 60 hours but up to 84 hours.
Setting
This extended monitoring is often performed in a specialized EEG monitoring unit within a hospital, an epilepsy monitoring unit (EMU), or sometimes in the patient's home with portable equipment.
Personnel
- EEG Technologists for placement of electrodes and monitoring.
- Neurologist specialized in EEG for data review, analysis, and interpretation.
- Support staff for technical assistance and patient care.
Risks and Complications
- Skin irritation or discomfort from the electrodes.
- Mild discomfort from wearing the equipment continuously.
- Rarely, anxiety or stress due to prolonged monitoring.
Benefits
- Accurate diagnosis and characterization of seizure types and frequency.
- Effective treatment planning based on detailed and extensive brain activity data.
- Reduced risk of seizure-related complications through better management.
Recovery
- No special recovery process is required.
- Patients can typically resume normal activities immediately after the recording period.
- Follow-up appointments may be scheduled to discuss results and treatment plans.
Alternatives
- Standard EEG (20-30 minutes) which may miss infrequent events.
- Ambulatory EEG (24-48 hours) for shorter-term monitoring.
- In-hospital video EEG monitoring, providing detailed seizure analysis but requiring hospitalization.
Patient Experience
Patients may feel some inconvenience from the extended duration and continuous wear of the electrode cap, which might interfere with routine activities and sleep. However, this monitoring is crucial for obtaining comprehensive data and is generally well-tolerated. Comfort measures such as taking breaks, engaging in calming activities, and maintaining a supportive environment can help manage any discomfort or anxiety during the procedure.