Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of EEG recording; with video (VEEG)
CPT4 code
Name of the Procedure:
Electroencephalogram (EEG), Continuous Recording with Video (VEEG)
Summary
An Electroencephalogram (EEG) with continuous recording and video monitoring (VEEG) is a diagnostic procedure in which electrical activity in the brain is monitored and recorded over a period of 2-12 hours. Video footage is also captured to correlate physical behavior with brain activity. This combined approach helps in diagnosing conditions like epilepsy and other seizure disorders more accurately.
Purpose
The VEEG is primarily used to diagnose or monitor:
- Epilepsy and other seizure disorders.
- Unexplained spells or episodes.
- Encephalopathy and other brain conditions.
The goal is to capture real-time data on brainwave patterns during suspected seizure activity and correlate it with physical manifestations.
Indications
- Patients with unexplained seizures or spells.
- Those experiencing recurring episodes of unconsciousness.
- Individuals with abnormal EEG results requiring further investigation.
- Pre-surgical evaluation for epilepsy surgery.
Preparation
- Patients are usually instructed to maintain a sleep-deprived state prior to the procedure to increase the likelihood of capturing seizure activity.
- Hair should be clean and free from hair products.
- Continue taking prescribed medications unless advised otherwise by a physician.
- Inform the care team of any implanted medical devices.
Procedure Description
- Preparation: Electrodes are applied to the scalp using a conductive paste or gel.
- Recording: The patient is connected to an EEG machine and a video camera. Brainwave activity and video footage are recorded continuously over 2-12 hours.
- Event Marking: Any behavioral changes or events are annotated either by the patient (through a button press) or by the technician.
- Review and Analysis: A physician or a qualified health care professional reviews the recorded EEG data and video footage to identify patterns consistent with seizures or other abnormal brain activity.
- Interpretation and Report: The collected data is analyzed, and an interpretive report is generated detailing the findings.
Duration
The procedure typically lasts between 2-12 hours, depending on the individual's condition and physician's recommendations.
Setting
The VEEG is usually performed in a specialized EEG monitoring unit within a hospital, outpatient clinic, or epilepsy monitoring unit.
Personnel
- Neurologist or Epileptologist
- EEG Technologist
- Nursing staff
Risks and Complications
- Minor skin irritation or discomfort from electrode application.
- Feelings of fatigue from sleep deprivation.
- Rarely, seizure induction due to the procedure setup.
Benefits
- Accurate diagnosis of seizure disorders and other neurological conditions.
- Identification of seizure type and origin.
- Improved management and treatment planning of epilepsy and other conditions.
Recovery
- After the procedure, the paste or gel used for electrode placement is cleaned off.
- Normal activities can usually be resumed immediately.
- Follow-up appointments may be scheduled to discuss results and treatment plans.
Alternatives
- Standard EEG: Lacks continuous monitoring and video correlation.
- Ambulatory EEG: Conducted over longer periods (days to weeks) but typically without concurrent video.
- MRI or CT scans: Imaging alternatives that provide structural, rather than functional, information.
Patient Experience
During the procedure, patients may experience minor discomfort from the electrodes and some fatigue due to sleep deprivation. Post-procedure, patients can expect to resume their normal routines quickly. Any discomfort is typically managed with reassurance and gentle skin care post-monitoring.