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Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG) recording and interpretation, each 24 hours, attended by a technologist or nurse

CPT4 code

Name of the Procedure:

Monitoring for Localization of Cerebral Seizure Focus by Cable or Radio, 16 or More Channel Telemetry, Electroencephalographic (EEG) Recording and Interpretation, Each 24 Hours, Attended by a Technologist or Nurse

Summary

This procedure involves continuous monitoring of brain activity using an EEG that records and interprets signals from 16 or more channels over a 24-hour period. The process is conducted under the supervision of a technologist or nurse to detect the focus of cerebral seizures.

Purpose

The primary aim is to pinpoint the specific area of the brain where seizures originate. This information is crucial for diagnosing epilepsy, tailoring treatment plans, and assessing surgical options for seizure control.

Indications

  • Recurrent, unexplained seizures
  • Diagnosis of different types of epilepsy
  • Pre-surgical evaluation for epilepsy surgery
  • Monitoring the effectiveness of anti-seizure medications

Preparation

  • Avoid caffeine for up to 12 hours before the test.
  • Continue taking prescribed medications unless instructed otherwise by a healthcare provider.
  • Clean, dry hair without any styling products.
  • Patients may be asked to reduce sleep the night before the procedure.

Procedure Description

  1. The patient arrives at the monitoring facility.
  2. Small electrodes are attached to the scalp using adhesive paste.
  3. The electrodes connect to an EEG machine via cables or a wireless radio system.
  4. Brain activity is continuously recorded over a 24-hour period.
  5. A technologist or nurse supervises the process to ensure data quality.
  6. The recorded data is interpreted by a neurologist.

Duration

The procedure lasts for 24 hours of continuous monitoring.

Setting

Typically performed in a hospital or specialized EEG monitoring unit.

Personnel

  • Neurologist (for interpretation)
  • EEG technologist or nurse (for setup and monitoring)

Risks and Complications

  • Skin irritation or discomfort from electrode adhesive
  • Minor risk of infection at electrode sites
  • Rarely, patient may experience anxiety or discomfort due to extended monitoring

Benefits

  • Accurate localization of the seizure focus
  • Improved diagnosis and treatment plans
  • Potential to identify candidates for epilepsy surgery
  • Enhanced understanding of seizure patterns

Recovery

  • Minimal recovery time; patients can resume normal activities immediately.
  • Patients may have follow-up appointments to discuss results and treatment plans.

Alternatives

  • Standard EEG, which offers shorter monitoring but less data.
  • Magnetoencephalography (MEG), providing more detailed brain activity mapping but at higher cost and limited availability.

Patient Experience

  • Patients may feel minor discomfort from the electrodes but typically experience little to no pain.
  • Mobility may be restricted due to the attached equipment.
  • Pain management is generally not necessary, but comfort measures can be taken as needed.

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