Have you ever seen someone have a seizure?

What is Video EEG Monitoring?

WHAT VIDEO EEG MONITORING IS:

Video EEGs help record both a patient's behavior and their brain activity.

"EEG-video monitoring refers to continuous EEG recorded for a more or less prolonged period with simultaneous video recording of the clinical manifestations. Having a correlation of the recorded behavior (video) and the EEG activity, the diagnosis of seizures or nonepileptic attacks can be made definitely in nearly all cases. EEG-video is the criterion standard for the diagnosis." - emedicine.medscape.com

screen shot of a Video EEG
(courtesy of simetronsac.com)
So boiled down, Video EEG Monitoring is the standard way doctors properly diagnose epilepsy and other conditions.  When Seizure The Day blogger Callie Sharon goes through her Video EEG, she will go through the following:
  • Callie will spend about a week in a medical facility.  
  • Doctors and their staff will connect electrodes to her head.
  • Callie can watch movies, read, eat, and hang out in her room at the medical facility.
  • During this time, doctors will monitor her 24/7.  They will capture video and compare that to the brain waves they record.

"Our understanding of epilepsy has been greatly advanced by video-EEG monitoring, which allows prolonged simultaneous recording of the patient’s behavior and the EEG. Seeing EEG and video data at the same time permits precise correlation between seizure activity in the brain and the patient’s behavior during seizures." - NYU Langone Medical Center

WHAT TO EXPECT FOR A VIDEO EEG:

How to prepare for a Video EEG:

  • Because electrodes used for video-EEG recording are glued to the scalp, make sure to wash your hair the night before and avoid hairspray, hair extensions, and any other things that will get in the way of the electrodes.  
  • "Give medicines as usual. Bring a list of all medicines (how much and when) you... take to the EEG Lab." - CHKD.org
  • Do not eat one hour before the test." - CHKD.org
  • You will most likely be bored.  Bring something to watch or do (movies, books, knitting, a pen and paper so you can write your "How I Got Through My First Video EEG" novel.
  • Alert family, friends, and co-workers that you will be MIA for a week. This is also a good opportunity to let anyone who doesn't know that you have epilepsy.  Spread awareness!

Other things to know about the Video EEG process:

  • Because of the aforementioned electrodes and the adhesive they use to connect the electrodes to your scalp for a week, you may want to bring a hat for the day you check out of the medical facility.
  • "Patients should expect to be fairly immobile (either in the bed or a chair), as they should be on camera at all possible times and will only have a limited extension of cord that allows them to use the restroom in private."  - NYU Langone Medical Center
That last one is important.  Privacy is important.  Most people go through their whole lives without peeing in front of a video camera.  Why start now?

HOW MUCH DOES A VIDEO EEG COST:

In Nebraska, a video EEG could cost up to $3,000 per day!

"For patients not covered by health insurance, an EEG typically... up to $3,000 or more if extended monitoring is required. For example, ... Saint Elizabeth Regional Medical Center in Nebraska, not including doctor fee, charges... about $3,000 for EEG monitoring and video recording for 24 hours." - health.costhelper.com

If you have health care (most people with epilepsy have to have health care) your health care provider typically pays 50%- 90% of those costs. - health.costhelper.com

There are a lot of factors which will affect the cost of your Video EEG.

Of course, this question, like all medical cost questions has a thousand answers.  The correct answer for you will depend on :
  • Whether you have health care.
  • Who your health care provider is (if applicable).
  • The facility which conducts your Video EEG.
  • How long will your Video EEG last?
  • Are you doing an in-patient Video EEG or the less accurate, at-home Video EEG?

"The best way to determine the actual cost for an EEG Test is to call the hospital or doctor's office and request the information. The billing department will be able to look up the information and give a comprehensive breakdown of the actual charges. They should be able to give this information before any appointment is booked for the test, though you may need to call with a code for that test to help them find the correct answer." - health.blurtit.com

VIDEO EEG BENEFITS:

Video EEGs allow doctors to properly diagnose and treat epilepsy and other conditions.

"Inpatient monitoring with close supervision allows the doctor to reduce and, in some cases, discontinue antiepileptic drugs safely. The medication reduction and possibly sleep deprivation, hyperventilation, exercise, or occasionally alcohol intake may be used to induce seizures. Video-EEG can be vital in the diagnosis of epilepsy and epileptic seizures. It allows the doctor to determine:
  • Whether events with unusual features are epileptic seizures
  • The type of epileptic seizure
  • The region of the brain from which the seizures arise
This last step is critical in assessing a patient for possible epilepsy surgery." - NYU Langone Medical Center

Callie has spent most of her life thinking she has Primary Generalized Epilepsy (PGE).  However, her husband, Jake Sharon has kept notes on all her seizures since they got married.  Based on those notes, her epileptologist, Dr. Sami Aboumatar thinks that the seizures Callie's seizures may actually be partial seizures- which, according to Dr. Aboumatar, are not typical for PGE. 
  
So, Dr. Aboumatar is demanding she undergo a Video EEG so he can properly diagnose her condition and prescribe the correct medication.  All parties involved want Callie to be seizure free.

"There are many different types of seizures which often are difficult to diagnose. Continuous video EEG monitoring is the most informative test for establishing the diagnosis of epilepsy and differentiating it from other forms of seizure activity. It is a non-invasive procedure that locates the region of the brain where seizures begin, making medical or surgical treatment more precisely targeted and successful. " -barnesjewish.org

Even if you don't have a seizure during your Video EEG, doctors can still learn from your Video EEG.

"When I spent a week in the video EEG unit, I didn't have a single seizure. Frustrating, irritating, and emotionally heartbreaking.... I hated not being able to have that seizure and post-ictal response to show the doctor. I felt as if I'd never get the help I desperately needed.
Yes, the epileptologist... can still make a diagnosis from his findings. He found (with me) that my brain waves were showing abnormal results and the misfiring was always coming from the left temporal lobe of my brain.... I now have a diagnosis and know the why and how of what is going on." -epilepsy.com