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Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored

CPT4 code

Name of the Procedure:

Electroencephalogram (EEG), Extended Unmonitored Recording

Summary

An electroencephalogram (EEG) involves recording the electrical activity of the brain over an extended period (12-26 hours) to monitor brain function. This particular type is unmonitored, meaning the data is recorded but not continuously watched by a technician during the procedure.

Purpose

The EEG helps diagnose and monitor conditions affecting brain activity such as epilepsy, sleep disorders, and other neurological conditions. The goal is to capture a comprehensive record of brain function which may reveal abnormalities not detected in shorter recordings.

Indications

  • Seizures or epilepsy diagnosis and monitoring
  • Unexplained episodes of unconsciousness
  • Sleep disorders
  • Evaluation of brain function in cases of coma or brain injury

Preparation

  • Wash hair the night before the test, avoiding any conditioners or oils.
  • Follow your physician’s instructions regarding medications.
  • Ensure a good night’s sleep before the test unless instructed otherwise.
  • Do not consume caffeine on the day of the test.

Procedure Description

  1. The technologist places small, flat metal discs (electrodes) on the scalp using a special paste.
  2. The electrodes are connected to an EEG machine which records the brain's electrical activity.
  3. The patient is instructed to perform certain activities (like blinking or taking deep breaths) and then remains in a relaxed state.
  4. The patient can move around within a limited area, but certain activities should be avoided to prevent artifacts in the data.
  5. Data is recorded continuously over 12-26 hours without real-time monitoring by a technologist.

Duration

12-26 hours

Setting

The procedure is typically performed in an outpatient clinic, hospital, or a specialized EEG monitoring unit.

Personnel

  • EEG technologist for electrode placement and setup
  • Neurologist or physician for reviewing the recorded data

Risks and Complications

  • Skin irritation from the electrodes
  • Discomfort from prolonged electrode placement
  • Rarely, minor skin infections

Benefits

  • Provides a comprehensive analysis of brain activity over an extended period
  • Higher likelihood of capturing intermittent or rare abnormal brain activities
  • Non-invasive and relatively low-risk

Recovery

  • No special recovery measures are necessary.
  • The patient can typically return to their usual activities immediately after the recording period.
  • Follow-up instructions may include reviewing the results with a neurologist.

Alternatives

  • Shorter-duration EEGs (routine EEGs)
  • Ambulatory EEGs for home monitoring
  • In-hospital continuous EEG monitoring with real-time observation
Pros and Cons
  • Extended EEG can capture rare events but is more time-consuming.
  • Routine EEGs are shorter but may miss infrequent abnormalities.
  • Real-time monitored EEGs provide immediate feedback but require constant supervision.

Patient Experience

  • The patient may feel mild discomfort from the electrodes but should not experience pain.
  • Activities are limited to prevent interference with the recording.
  • Adequate sleep and relaxation should be prioritized during the monitoring period. Pain management isn't typically required but should any discomfort arise, minor adjustments can be made by the technologist.

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