Long-term Video-EEG monitoring

Long-term or "continuous" video-electroencephalography (EEG) monitoring is a diagnostic technique commonly used in patients with epilepsy. It involves the long-term hospitalization of the patient, typically for days or weeks, during which brain waves are recorded via EEG and physical actions are continuously monitored by video.

Long-term video-EEG monitoring techniques developed from commonly used techniques involved in standard EEG testing.

Long-term video-EEG monitoring is utilized in the localization of epileptogenic zones (or the areas of the cortex of the brain responsible for epileptic seizures). Long-term video-EEG monitoring is similar to EEG in that the brain waves are periodically monitored and analyzed by a neurologist, typically one trained in clinical neurophysiology. The neurologist determines when the monitoring is finished and issues the final report after compiled data is interpreted.

The results from the EEG and video monitoring are used to characterize episodic disruptions in brain function and its physical manifestations; many recordings show symptoms of epileptic seizures over time and how severe and frequent the seizures become over a given period.

In this regard, the purposes of long-term video-EEG monitoring include discovering where in the brain seizures begin for a given subject, the severity of the seizures (measured according to a scaled order), determining frequency the seizures, the duration and prominence of physical activity during the seziure (which may be indicator of status epilepticus, prolonged seizures or increased frequency of seizures without a return to an otherwise normal state), and distinguishing epileptic seizures from psychogenic non-epileptic seizures. Additionally, audio recordings of patients (verbal and nonverbal) may be taken of the subject during those seizures. Each of these topics may then be used to evaluate a subject's candidacy for surgery to treat epilepsy.

In adults, long-term EEG monitoring typically involves one of three procedures which include long-term video-EEG monitoring, sleep-deprived EEG monitoring, and 24-hour ambulatory monitoring. Long-term video-EEG monitoring typically lasts from a few hours to several days, depending on the needs of the patient where sleep-deprived and ambulatory EEG monitoring are often used to further investigate symptoms of epilepsy when a standard EEG reading returns negative results.

Long-term video-EEG monitoring is typically used in cases of drug-resistant epilepsy to examine symptoms before surgery and is also used to more precisely diagnose a patient when episodes become more frequent.

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