VEEG Monitoring

If your diagnosis is unclear, or if you are not responding to anti-seizure medications, your epilepsy physician may suggest additional testing such as inpatient Video/EEG (VEEG) telemetry monitoring. VEEG monitoring is performed in the hospital with the goal of more clearly defining the type or types of seizures a patient is having. Your doctor uses this information to recommend specific treatments for your type of seizure disorder. Treatments may include medication, counseling or surgical intervention. 

Video EEG monitoring is more complicated than a typical outpatient EEG (electroencephalogram). VEEG monitoring takes place over several days while you are an inpatient in the hospital. During that time, your brain waves are continuously recorded with electrodes glued to your scalp. In addition, you are on camera and a microphone records sounds in the room. The goal of VEEG monitoring is to see what you do during your seizures. To increase the chance of capturing seizures, your anti-seizure medications are typically decreased or discontinued while your are in the hospital. If you have specific triggers for your seizures, we encourage you to use them. Because of the significantly increased risk of seizures while you are off medications, we ask that you stay in your room while you are in the hospital. We also recommend that you have a friend or family member stay with you, if possible. VEEG monitoring typically takes 4-7 days for adults and 2-4 days for children, but can end sooner or later depending on whether or not you have some of your typical events.

As a part of our team approach, our neuropsychologist and epilepsy social worker will see you while you are in the hospital for VEEG monitoring. Our neuropsychologist may give you standardized neuropsychological tests to determine whether your seizures have altered your memory or the way you use language, and will review these results with you before you leave the hospital. Our social worker will talk with you about how your seizures may be affecting your life in terms of employment, interpersonal relationships, school or finances.

VEEG Frequently Asked Questions

We hope the following information will help you in planning for your upcoming VEEG monitoring stay.  We will be happy to clarify or answer any other questions you may have. Call us at 206-386-3880 or 1-800-331-7533 if you need more information.

What is Video EEG monitoring?

Video EEG (VEEG) monitoring is a continuous recording that combines EEG recording (electroencephalography) with video recording. It is performed in the hospital while you are an inpatient. The purpose of VEEG is to record your spells and determine if they are seizures or some other condition. Recording your brain waves allows us to potentially capture your spells, categorize them and hopefully pinpoint their origin in the brain. This helps guide your doctors to prescribing the best treatment(s).

Why do I need VEEG monitoring?

VEEG will provide more information than just a short outpatient EEG can. With VEEG, the doctor has access to information gathered over several days and includes the recording of your seizures. VEEG is the only way to determine what your brain waves do during an event. This can be very useful in diagnosing your condition.

How is VEEG set up?

You will be admitted to a private room in the neuroscience unit at the Cherry Hill campus of Swedish Medical Center. Pediatric patients will be admitted to the First Hill campus. The room will have a digital camera mounted near the ceiling. You will have EEG electrodes placed on your head. The electrodes have wires extending from them. These wires will be connected to a transmitter that is about the size of a book. Attached to the transmitter is a long cord that goes into the wall and connects to the computerized recording system. The camera is turned on and records, along with the EEG recording, 24 hours a day. We ask that you or a family member push the seizure-alert button whenever you have a seizure.

Why do I need someone to stay with me?

A family member or friend who is familiar with your seizures should plan to stay with you to help report the time, type and number of seizures you may have. If you are unable to press the seizure-alert button during a seizure, this person would be available to push the button. This person would also be available to help identify the type of spells in question. Children and disabled adults, or persons with convulsive or grand mal seizures, are required to have someone stay with them at all times. Only one person may stay overnight in the room due to space limitations and the need for staff to access safety equipment. A rollaway bed will be provided. 

What should I bring with me to the hospital?

• Bring comfortable clothing for lounging. Be sure that your shirts button or have zippers.  Do not bring any shirts that you have to pull over your head; otherwise you will not be able to change your shirt during your stay.

• Bring your toiletries.

• Bring "quiet time" activities, such as books, puzzles, cards, etc.

• You may bring a favorite pillow or blanket, but do not bring a white pillowcase or white blanket.

• Cell phones may not be used and cannot be turned on in the hospital.

• Electronics should be powered by batteries only.

• Bring your medications in properly labeled prescription bottles.

• In general, items of value should be left at home.

Do I need to stay in bed the whole time? 

Most of the time you will need to stay in the bed. A chair can be set next to the bed so that you can sit on occasion. A stationary bicycle is available and can be brought into your room. Whenever you get out of bed, someone should be standing by you, in case you have a seizure. You will not be able to leave your room while you are being monitored. It is important that you stay in view of the camera at all times. (There is no camera in the restroom.)

How long will I be in the hospital? 

The average length of stay is a week, give or take a day or two. The length of stay will depend on how long it takes for you to have seizures that can be recorded.

What if I don't have a seizure? 

There are some things that can be done to try and trigger your seizures, such as lowering or stopping your seizure medication and getting very little sleep. We will try to keep you in the hospital until you do have seizures. This may extend beyond a week.

Will I be able to shower? 

You will not be able to shower or shampoo your hair during the time that you have the electrodes on. The nursing staff will help set you up for "sponge bathing" at the bedside or sink.

May I chew gum? 

You will not be able to chew gum because it interferes with the recording.

May I smoke? 

Swedish Medical Center is a smoke-free facility. Smoking is not permitted anywhere on Swedish property. Your doctor can prescribe nicotine patches for you during your VEEG stay if needed.

Is there a phone in the room? 

There is a phone in each room which you can use for local calls. If you need to make a long-distance call during your stay, you will need to bring a calling card with you. Cell phones must not be used because they will interfere with the recording equipment.

May I have visitors? 

Yes. Visiting hours are from 9 a.m. to 9 p.m. The family member or friend staying with you will stay beyond these hours. Visitors may be asked to leave the room during testing or treatments. 

What kinds of tests will I have? 

Neuropsychological (cognitive) testing is often done. This may includes tests of your memory, language, concentration, spatial abilities, etc. This testing measures the functioning of the various areas of your brain. This is NOT pass/fail type of testing. Other tests may include specialized brain scans. You may also have periodic blood draws for laboratory testing.

What about meals? 

Meals will be provided for you and served in your room. You may order from a menu provided by the Nutrition Department. The family member or friend staying with you must pay for their own meals. For their convenience, Swedish has a cafeteria with a broad range of menu selections.

What happens at the end of VEEG? 

Prior to your discharge, you will be placed back on your seizure medication. You will discuss the results of the VEEG with your doctor. After you are discharged from the hospital, you should follow up with your referring doctor and/or your epilepsy physician.

Will my insurance company pay for VEEG? 

Most insurance plans have a benefit covering VEEG. Our Epilepsy Center will get precertification or preauthorization for the admission. However, insurance companies do NOT guarantee payment. It is important that you check with your insurance company to see what your coverage is, so that you know what your out-of-pocket expenses might be.

What if I have to cancel my VEEG? 

Please notify the Epilepsy Center if you are unable to make your VEEG appointment. If you need to cancel your appointment after office hours and during the weekend, please call the 5-East Nurses Station at Swedish/Cherry Hill at 206-320-2530 and ask to speak to the charge nurse. For pediatric patients, please call the 6-Southwest Nurses Station at Swedish/First Hill at 206-386-6206.