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Electroencephalogram (EEG); including recording awake and asleep

CPT4 code

Name of the Procedure:

Electroencephalogram (EEG); also known as brain wave test

Summary

An EEG is a non-invasive test that measures and records the electrical activity of the brain. This activity is captured using small, flat metal discs called electrodes, which are attached to the scalp. The test can be conducted while the patient is awake or asleep and helps in diagnosing various neurological conditions.

Purpose

An EEG is used to detect abnormalities in the brain's electrical activity, which can indicate conditions such as epilepsy, brain tumors, sleep disorders, and other neurological issues. The goal is to identify irregular brain activity that may be causing symptoms like seizures, confusion, or other cognitive issues.

Indications

  • Unexplained seizures
  • Recurrent headaches or migraines
  • Sleep disturbances or disorders
  • Changes in consciousness or unexplained confusion
  • Monitoring brain activity in patients with known neurological conditions

Preparation

  • Wash hair the night before and avoid applying any hair products (e.g., gels, sprays).
  • Continue taking prescribed medications unless instructed otherwise by the doctor.
  • Avoid caffeine and other stimulants for at least 8 hours before the test.
  • For EEGs that include sleep recording, patients may be asked to reduce sleep the night before.

Procedure Description

  1. The patient is asked to lie down or sit in a comfortable position.
  2. Electrodes are attached to the scalp using a conductive paste or gel.
  3. The patient remains still and may be asked to perform specific tasks like breathing deeply or looking at a flashing light.
  4. If sleep recording is included, the patient will be given time to fall asleep naturally.
  5. The EEG machine records the brain's electrical impulses, which appear as wavy lines on a computer screen or paper.

Duration

The procedure typically takes about 45 minutes to 2 hours, depending on whether both awake and asleep states need to be recorded.

Setting

EEGs are usually conducted in a hospital's neurological department, an outpatient clinic, or a specialized sleep center.

Personnel

  • Neurologist
  • Trained EEG technician

Risks and Complications

  • Minor discomfort due to the sticky electrodes on the scalp
  • Possible skin irritation from the electrode paste or gel
  • In rare cases, hyperventilation or flashing lights may trigger a seizure in susceptible individuals

Benefits

  • Provides critical data for diagnosing neurological conditions
  • Non-invasive and relatively quick
  • No exposure to radiation or harmful substances
  • Results can aid in effective treatment plans and management of conditions

Recovery

  • No downtime; patients can resume normal activities immediately after the procedure.
  • Any paste or gel used can be washed out of the hair.
  • Follow-up appointments may be scheduled to discuss results and further steps.

Alternatives

  • Magnetic Resonance Imaging (MRI)
  • Computed Tomography (CT) scan
  • Positron Emission Tomography (PET) scan
  • Each alternative has its pros and cons, such as higher cost or exposure to radiation, but may provide different types of information about brain structure and function.

Patient Experience

During the procedure, the patient may feel mild discomfort from the electrodes. The test itself is painless. If sleep recording is required, the patient might feel drowsy. After the test, any residue from the conductive paste or gel can be washed off. It's a generally well-tolerated procedure with minimal discomfort.

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