Experts talk about the importance of 24 hour long range video EEG.

Experts talk about the importance of 24 hour long range video EEG.

Video-electroencephalogram (V-EEG) is a combination of electroencephalogram monitoring system and video recording device to record the clinical manifestations and electroencephalogram of epileptic seizures synchronously. Doctors can observe the clinical manifestations of epileptic seizures carefully according to video data and compare them with synchronous electroencephalogram records so as to more accurately determine the type and feasibility of epileptic seizures. At the same time, it can accurately grasp the patient's activity state and corresponding EEG changes in various time intervals, detect and eliminate all kinds of interference artifacts and electrode faults in time, and improve the accuracy and reliability of EEG monitoring results. The following are the related questions of EEG monitoring.

1. Is video EEG necessary before epilepsy surgery?

The most important factor in deciding the surgical treatment of intractable and focal epilepsy is that after the preoperative evaluation of the patient's treatment, the results of different evaluation schemes on the source of epilepsy are consistent.  These assessments include: epileptic seizure symptoms, intermittent electroencephalogram, epileptic electroencephalogram, neuroimaging, and all neuropsychological tests associated with the lesion. Long-term video-electroencephalogram (V-EEG) monitoring can simultaneously provide the clinical manifestations of seizures, intermittence electroencephalogram and epilepsy electroencephalogram. It plays an important role in the surgical treatment of epilepsy and is an indispensable part of preoperative examination of epilepsy surgery.

2, do EEG examination do harm to human body?

Electroencephalogram (EEG) is a non-invasive method. We place electrodes on the scalp of the human body. Instead of conducting electricity to the head, the electrodes and wires lead the spontaneous and rhythmic weak electrical signals of brain cells out. The electroencephalogram is amplified, filtered and processed by the EEG machine and reflected on the computer screen. On the screen, different patterns of EEG activity were obtained, so as to judge the brain condition of the patients. Therefore, if we understand the working principle and mechanism of EEG, we can draw a conclusion that EEG examination is not only harmless to human body, but also an indispensable means to understand the patient's condition, timely treatment and recovery of health.

3. Have done CT or magnetic resonance imaging (MRI) examination, why should we do video-EEG monitoring? Ltd.

CT or magnetic resonance imaging (MRI) is an imaging examination, can only distinguish whether there are abnormalities in the brain structure, imaging detection of lesions is not equal to epileptic focus. Video electroencephalogram (V-EEG) monitoring can distinguish whether there is abnormal brain function, and epileptic foci can be found directly. Epileptogenic foci detected by electroencephalogram sometimes need to be confirmed by CT or MRI before they can be located accurately. So the location of epileptogenic foci is indispensable to two kinds of examinations.

4. What preparations should be made before video EEG (V-EEG) monitoring?

(1) The doctor notifies the patient to do the video-EEG examination, tells him the purpose of the examination and the time to go on the computer, explains clearly the examination requirements to the patient, eliminates the patient's worries, so that the patient can fully understand and cooperate with the examination, and provides relevant medical history information.

(2) before examining, the patient should clean his head and cut his hair if necessary. Do not smear hair oil, wax, mousse and other substances.

(3) After entering the video surveillance ward, the patient needs to be accompanied by relatives to help the patient alert and observe, record and describe the patient's performance during the attack and the relevant information required by the doctor.

(4) Patients and caregivers should turn off their mobile phones, computers and video games after entering the video surveillance ward to avoid electromagnetic interference affecting the accuracy of EEG examination.

(5) for patients who are too young or unable to cooperate, oral chloral hydrate or enema should be given if necessary.

5. What are the precautions and requirements for video EEG (V-EEG) examination? Ltd.

(1) Patients in the video-electroencephalogram (V-EEG) monitoring process bedside guardrail must be erected, in order to avoid the onset of accidental injury.

(2) During the whole process of video-electroencephalogram (V-EEG) monitoring, all patients'activities should be controlled within the scope of the camera lens, and the connection of the electrode wires should be kept reliable to ensure the quality of V-EEG monitoring.

(3) do not play, noisy or noisy in the monitoring ward, keep the ward quiet and comfortable.

(4) caregivers should not sleep with patients. The accompanying staff should immediately ring the bell and alarm the patient when the attack occurs. Do not press and pull the patient, do not block the camera lens, and lift the patient's cover to observe the patient's performance during the attack, and pay attention to the safety of the patient. Record the time and condition of the patient in detail.

(5) Nurses should immediately observe the patient's attack, and open the quilt to see if the lens is blocked, closely observe the attack and clinical manifestations, to observe the patient's consciousness, while turning the patient's head to one side, remove the pillow, in order to prevent patients with respiratory obstruction. Make relevant records in time.

(6) patients should be given oxygen inhalation immediately after the attack. In case of emergency, they should be informed of the treatment in time.

(7) Electroencephalogram (EEG) monitors should regularly inspect and monitor the ward, timely understand the patient's seizures, and check the connection status of electrode wires.

(8) Electroencephalogram (EEG) monitors should monitor patients and their records continuously, closely and directly, so as to quickly identify the occurrence of sexual events and technical faults in EEG records. In special and suspicious cases, it is necessary to keep a good record, and the effective and detailed test results obtained from this will be of great significance to the diagnosis of epilepsy and localization of epileptogenic areas.

6. How long does it take to monitor video EEG (V-EEG)?

The most important way to improve the positive rate of EEG diagnosis is to extend the recording time. Some seizures occur only at night; some seizures and electroencephalographic abnormalities occur mainly after waking up in the morning or just before waking up; others occur only during sleep epileptic discharge patterns. Episodes of interictal epileptic discharges that are less frequent may be activated by sleep. So in principle, video EEG (V-EEG) monitoring usually takes more than 24 hours and includes sleep process. Patients assessed prior to epilepsy sometimes need longer monitoring to capture multiple habitual seizures.

7. Is it necessary to stop antiepileptic drugs during video surveillance (V-EEG)? Ltd.

Video-electroencephalogram (V-EEG) monitoring before epilepsy surgery must record 2-3 or more habitual seizures in order to provide reference for preoperative localization. For patients with frequent episodes can not stop the drug, rare and can not tolerate long-term monitoring of patients, if necessary, by reducing the drug, stop to induce seizures to achieve monitoring purposes. However, drug reduction and withdrawal may change the original seizure pattern and epileptic discharge, so in principle the specific circumstances should follow the doctor's advice.

8. Why do we have video EEG (V-EEG) monitoring and have to go to the computer two times?

As mentioned earlier, epileptic foci can be accurately located only when the clinical manifestations, intermittent EEG and epileptic EEG are consistent in the preoperative assessment of epilepsy. However, the clinical manifestations of seizures in some epileptic patients are more complex, and there are many forms of electroencephalogram during the intermission and the onset of epilepsy. Therefore, it is necessary to go to the computer twice or even many times, and if necessary, to carry out invasive intracranial electrode (video) EEG monitoring to achieve the purpose of accurately locating epileptic focus.

9. Do video EEG (V-EEG) monitoring have to be seized? No seizure, can we get off the plane?

For patients undergoing preoperative assessment of epilepsy surgery, habitual seizures should be captured at least 2-3 or more times in principle. For patients with very low frequency of seizures who fail to grasp the seizure during long-term video-electroencephalogram (V-EEG) monitoring, if their clinical manifestations are stereotyped, intermittent electroencephalogram (EEG) and imaging examinations can help locate the seizure accurately, they can be removed without seizures.

10, during video surveillance (V-EEG) monitoring, there have been episodes. Why should we continue to monitor it?

Clinically, it is more meaningful to capture the same attack as usual, called habitual seizure. Only at least 2-3 episodes of habitual seizures can be meaningful for locating epileptogenic foci.