Portable Video EEG
Why Portable Video EEG?
The EEG is often used to assist the physician in diagnosing seizure disorders. Abnormalities in the EEG such as spikes or Spike/wave may be indicative of specific types of seizures, however a normal EEG does not rule out the possibility of the patient having seizures. Due to the relatively short length of a routine EEG and the variability of epileptiform activity there may be a chance of “missing” the abnormalities needed to make the proper diagnosis Portable Video EEG provides the opportunity to record the EEG for an extended period of time, typically 24- 72 hours, in which you may have a greater likelihood of capturing these abnormalities.
Portable Video EEG is very helpful in differentiating seizure types, determining seizure frequency and distinguishing non-epileptic from epileptic seizures. Psychogenic seizures are often initially misdiagnosed and treated with medications when more appropriate therapy is warranted.
Simultaneous EEG and video recording have traditionally been confined to the hospital. With better technology we are now able to provide simultaneous EEG and video recordings as an out patient. This allows the physician to obtain high quality monitoring while the patient is in a more comfortable home environment. The length of the recordings may extend until the seizure is captured but is typically done for 72 hours.
Some situations the Physician may want to order Portable Video EEG include:
- Differentiation of seizure type
- Quantification of seizures
- Medication adjustments
- Question psychogenic seizures
- Differentiate movement disorders from seizures
- Syncope or seizure
- Parasomnias and other Sleep disturbances
- Episodic confusion, disoriented behavior
- Complex migraine
- Visual or auditory Hallucinations
- Loss of contact with environment
Frequently Asked Questions (FAQ)
When do I order a Portable Video EEG?
A Portable Video EEG is helpful in differentiating seizure types, seizure frequency and distinguishing epileptic from non epileptic seizures and is also helpful in distinguishing syncope from seizures.
How long is the study ordered for?
Typically a 72 hour study is requested, however the study can be as short as 24 hours or until the event in question is captured.
How are the patients scheduled?
The referring physician's office will fax or e-mail the referral form to Physicians Ancillary Service LLC. The patient will be contacted and scheduled at the patient's earliest convenience. Confirmations of patients scheduled study dates can be sent to your office by fax or email.
Who performs the study, and where?
Registered and trained EEG techs will perform the electrode application for your patient at their home, or if preferred, your office. The techs will disconnect the patient at the conclusion of the study. Yes this includes weekends.
Who will interpret the study?
There are two available choices. The referring physician can interpret the study or Physicians Ancillary Services LLC can provide a physician to interpret the study.
Is there any financial commitment or investment on my part?
No. We provide the equipment, technicians and technical infrastructure. You benefit from excellent quality studies to help diagnose patients with significant ancillary revenue for your practice.
How is billing handled?
The referring physician bills the study. The reading physician receives the professional component and Physicians Ancillary Service LLC will invoice for the technical component.
Does the study require preauthorization?
Portable Video EEG is considered an out patient service so typically, no preauthorization is required. As always, when unsure, have office staff verify whether authorization is required.
Does Medicare cover this study?
Preparation for the study:
The set up generally takes between 60 to 90 minutes
- Hair should be washed the morning of the study. Please do not use any styling gels, oils or hair spray. The scalp must be clean and the hair thoroughly dried for the best electrode application.
- The electrodes are applied with a special adhesive that is needed to keep the electrodes in place for prolonged recordings.
- Wear a button down shirt or blouse. It is easier to change without pulling something over your head.
- Bring a hat or scarf. Some people feel conscience about wearing the electrodes in public. Your head will be lightly wrapped with gauze to assure better electrode contact.
The duration of the study is typically between 24 and 72 hours. In some cases your physician may order a study that will run until the episodes in question are captured. Please do not terminate the study before contacting the EEG staff. While the study is being recorded it is important to log your activities in the patient diary sheets. For example: The time of meals, bed time and awakening, dosing of medications as well as the “push buttons”. Push button events should always be recorded in the diary with the symptoms that led to the patient pressing the push button event marker located on the recorder.
The patient must not let the electrodes or recorder get wet. Showers and tub baths should not be taken while the study is being recorded. Sponge baths are fine and changing of the EKG electrodes is also permitted. Please do not chew gum or suck on hard candy and limit cell phone use as these activities may interfere with getting high quality EEG signals. We know that it gets itchy after a while but try not to scratch or pick at the electrodes. Please call us if one of the electrodes becomes loose or falls off.
When the study is being run with simultaneous video recording, it is important to spend as much time on camera as possible. The recording should always be recorded while sleeping. Please call us if there any problems with the video recording.
The removal of the electrodes is usually done by the office staff where the electrodes were applied. The electrodes are removed with a special adhesive remover or acetone. Following disconnection of the electrodes there may be some residual glue in your hair. This can be removed by putting conditioner in your hair prior to washing and with repeated combing.