Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpret
CPT4 code
Name of the Procedure:
Electroencephalogram (EEG), Continuous Recording and Interpretation
Summary
An Electroencephalogram (EEG) is a test that records electrical activity in the brain. In this procedure, continuous EEG recording is performed over a period extending beyond 12 hours but not exceeding 26 hours. A physician or qualified health care professional reviews the recordings, analyzing for any spike and seizure activity.
Purpose
The primary purpose of a continuous EEG is to monitor brain activity over an extended period to detect abnormal electrical discharges, such as spikes and seizures, which may not be caught in shorter recordings. This helps in diagnosing neurological conditions like epilepsy, sleep disorders, and other brain dysfunctions.
Indications
- Recurrent seizures or epileptic activity
- Unexplained periods of unconsciousness or alterations in mental state
- Diagnosing and monitoring sleep disorders
- Assessment of head injuries or brain dysfunction
- Evaluating the effectiveness of anti-epileptic medication
Preparation
- Wash hair the night before the test and avoid using hair products like gels or sprays.
- Follow specific instructions given by the healthcare provider regarding medications. Some may need to be adjusted.
- No caffeine consumption prior to the test.
Procedure Description
- Placement of Electrodes: Small metal discs called electrodes are attached to the patient's scalp using a special paste or cap.
- Continuous Monitoring: The EEG machine continuously records brain activity for a period of 12 to 26 hours while the patient engages in normal daily activities, including sleep.
- Review and Analysis: A physician or qualified healthcare professional regularly reviews the recorded EEG data, marking any spikes or seizure activity.
- Interpretation: At the end of the recording period, a detailed analysis is performed to interpret the findings.
Duration
The recording lasts for more than 12 hours and up to 26 hours.
Setting
The procedure can be done at a hospital, outpatient clinic, or specialized EEG monitoring unit.
Personnel
- Neurologist or epilepsy specialist
- EEG technologist
- Nursing staff
Risks and Complications
- Mild discomfort or skin irritation where electrodes are placed
- Potential allergic reactions to the paste or adhesive
- Rare risk of triggering a seizure during the recording
Benefits
- Comprehensive monitoring provides better detection of intermittent and rare electrical abnormalities.
- Aids in accurate diagnosis and finer adjustment of treatment plans.
- Helps in monitoring the effectiveness of ongoing treatments.
Recovery
- No recovery time is generally required; patients can return to normal activities immediately after the procedure.
- Follow any additional instructions given by the healthcare provider.
- Schedule follow-up appointments to discuss the results and further treatment if needed.
Alternatives
- Shorter-duration EEG recording
- Ambulatory EEG, which allows for more extended monitoring at home
- Magnetic resonance imaging (MRI) or computed tomography (CT) scan for structural brain evaluations
- Pros and cons: Shorter EEGs are less likely to capture intermittent events, and ambulatory EEGs offer similar benefits but may be less controlled than in-clinic monitoring.
Patient Experience
- The patient might feel slight discomfort from the electrodes but will generally be comfortable as they can move around and perform usual activities.
- Pain management is not typically needed, but nurses and technologists ensure comfort throughout the procedure.
- The patient should be able to rest and sleep as usual during the monitoring period.