Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance
CPT4 code
Name of the Procedure:
Electroencephalogram with Video Monitoring (VEEG)
Summary
An Electroencephalogram with Video Monitoring (VEEG) is a diagnostic test that measures electrical activity in the brain while simultaneously recording video footage of the patient. This is typically done over an extended period (12-26 hours) to monitor for seizures or other abnormal brain activities. The data is reviewed and analyzed by an EEG technologist.
Purpose
The primary purpose of a VEEG is to diagnose and monitor epilepsy and other neurological conditions affecting brain function. The goal is to capture electrical brain activity during seizures to determine their type and origin, which aids in tailoring appropriate treatments.
Indications
- Unexplained seizures or spells
- Suspected epilepsy
- Evaluation of seizure type and frequency
- Assessment for surgical treatment of epilepsy
- Monitoring response to epilepsy treatment
Preparation
- Patients may be asked to adjust their medication regimen under the guidance of their healthcare provider.
- Fasting is generally not required, but patients should follow specific instructions from their physician.
- Prior to the test, patients may be asked to wash their hair and avoid any styling products to ensure good electrode contact.
Procedure Description
- Electrode Placement: Small, flat metal discs (electrodes) are placed on the patient’s scalp using a conductive adhesive.
- Video Setup: A camera is positioned to continuously record the patient’s movements and behaviors during the test.
- Monitoring: The patient is monitored in a comfortable setting (usually a hospital room equipped for extended EEG monitoring). The patient may be asked to press a button or alert staff if they feel a seizure coming on.
- Intermittent Technologist Review: An EEG technologist intermittently reviews the data and video footage to ensure proper functioning and to capture relevant events.
- Maintenance: The technician or nursing staff will periodically check on the patient to ensure electrodes remain in place and the system is functioning correctly.
Duration
The procedure typically spans 12-26 hours, depending on the clinical need and protocol.
Setting
The procedure is usually performed in a hospital’s epilepsy monitoring unit or a specialized outpatient clinic equipped for long-term monitoring.
Personnel
- EEG Technologist
- Neurologist or Epileptologist
- Nursing staff
Risks and Complications
- Minor skin irritation or discomfort where electrodes are attached
- Potential for seizures during monitoring, which are managed by the medical team
- Privacy concerns due to continuous video recording
Benefits
- Detailed and comprehensive assessment of brain activity and behavior
- Accurate diagnosis and classification of seizure types
- Improved treatment planning and management of epilepsy
Recovery
- Little to no recovery time is needed for the EEG itself.
- Patients may be slightly fatigued due to the extended monitoring period.
- Follow-up may involve reviewing the results with a neurologist to discuss findings and treatment plans.
Alternatives
- Standard EEG: Short-term monitoring without video
- Ambulatory EEG: Patient wears the equipment at home for up to 72 hours
- MRI or CT Scan: Imaging tests that provide different types of brain information
Patient Experience
- Patients may feel mild discomfort from electrodes and prolonged monitoring.
- They can usually move around within the room but should stay seated or reclining when possible.
- Pain management is not typically necessary, and staff are available to ensure comfort.