What is VEEG monitoring?
Neuroscience Institute Epilepsy Center
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 ask 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 206-320-3492 or 1-800-331-7533 if you need more information.
What is Video EEG monitoring?
Video-EEG (VEEG) monitoring is a procedure done during an inpatient hospital stay using continuous recording of EEG and video. The goal is to record your usual events and determine if they are epileptic seizures or some other condition. For epileptic seizures, the VEEG can help determine the type of seizure and may pinpoint the area in the brain where they begin.
Why do I need VEEG monitoring?
VEEG will provide more information than just a short outpatient EEG. Often your doctor has not witnessed one of your events. With VEEG your doctor has several days of both EEG and video recording. This allows your doctor to view your behavior and EEG readings before, during and after a seizure-like event. This can be very useful in diagnosing your condition and determining treatment options.
How is VEEG set up?
Adults will be admitted into a private room of the Neuroscience Unit, floor 5 East at the Swedish Cherry Hill campus (500 17th Avenue, Seattle 98122). Children will be admitted into a private room of the Pediatric Unit, floor 9 East at the Swedish First Hill campus (747 Broadway, Seattle 98122).The room will have a digital camera mounted near the ceiling and focused on you in the bed. You will have EEG electrodes glued on your head. The electrodes wires will connect to a transmitter about 4 by 7 inches in size. Attached to the transmitter is a very long cord that goes into the wall and connects up to the computerized recording system. The camera and the EEG are recording 24 hours a day. We ask that you or the person with you push the seizure alert button whenever you suspect a seizure.
Why do I need someone to stay with me?
We request that you make every effort to have a family member or friend stay with you in your hospital room throughout your stay. It is especially important for disabled adults and persons with grand mal (convulsive) seizures to have someone with them at all times. If you are unable to recognize that you are having a seizure or cannot press the seizure alert button during a seizure, this person would be available to do so. When the seizure button is pressed, medical staff will come to the room immediately to provide assessment and care. Your family member or friend may also be able to tell your doctor whether the event was typical or different from the ones that you usually experience. If you cannot have someone stay or your escort can only stay part of the time, please discuss this with your doctor or another Epilepsy Center staff person ahead of time.
Only one person may stay overnight in the room due to space and the need for staff to access safety equipment. The person with you will be provided with a sleeper chair that unfolds to a flat surface for sleep. Linens and a pillow will be provided. Please have your friend or family member plan ahead and let the nursing staff know when they need to take a break or step out of the room.
What should I bring with me?
Bring your medications in properly labeled prescription bottles. Bring comfortable clothing for lounging. Be sure that your shirts are button down, or have zippers. You should not bring any shirts that you have to pull over your head; otherwise you will not be able to change your shirt. Bring your toiletries. Bring “quiet time” activities, such as books, puzzles, cards, etc. You will have a DVD and VHS player in your room so bring your tapes or DVDs. You may bring a favorite pillow or blanket but do not bring a white pillowcase or white blanket. Cell phones may be used. You may bring your laptop. Computers and electronics should be powered by batteries. The staff may ask that electronic devices be turned off or not used if there is interference on the EEG recording. In general, items of value should be left at home. You may ask at the Registration Desk when you are admitted to have valuables stored in the hospital safe. You may take these items out only one time so you will not have in and out access throughout your stay.
Do I need to stay in bed the whole time?
Yes, you need to stay in your room, in your bed. This policy is for your safety and to keep you on camera. No exceptions to this policy without an order from your Epilepsy Center doctor. You will ring for staff assistance when you need to use the restroom. Whenever you get out of bed, a staff person should be standing by in case you have a seizure. It is important that you stay in view of the camera at all times. Of course, there is no camera in the restroom.
What about using the restroom?
There is not a video camera in the restroom. Measures are made to protect your privacy. However, the restroom door must be cracked to allow nursing staff to check for seizure activity. This is for your safety.
How long will I be in the hospital?
The average length of stay is a week, give or take a day or two. Length of stay will depend on how long it takes for you to have seizures to record.
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 or tobacco? May I smoke cigarettes?
You will not be able to chew gum or tobacco as it interferes with the recording. Swedish Medical Center is a smoke-free facility. The policy is no smoking anywhere on hospital property. Your doctor can prescribe nicotine patches for you during your VEEG stay.
Is there a phone in the room?
There is a phone in each room, available for local calls. You may also use your cell phone.
May I have visitors?
Yes. Visiting hours are 9:00 AM to 9:00 PM. The family member or friend staying with you will stay beyond these established hours. Visitors may be asked to leave the room during testing or treatments.
What kind of tests will I have?
Neuropsychological (cognitive) testing is often done. This is testing 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. Your family or friend staying with you must pay for their own meals. They can pay with cash, a credit card, or a debit card. They will go down to the cafeteria to get their meals. They can bring a tray and eat in your room. The Cherry Hill cafeteria does not accept Alaska Medicaid vouchers as payment for your family member or friend’s meals. The Cherry Hill cafeteria hours are Monday through Friday 6:30am to 7:30pm, and Saturday and Sunday 7am to 1:30pm.
What happens at the end of VEEG?
Prior to your discharge you will be placed back on your seizure medication. You will discuss with your doctor the results of the VEEG. After you are discharged from the hospital, you should follow up with your referring doctor and/or your epilepsy doctor.
Will my insurance company pay for VEEG?
Most insurance plans have a benefit covering VEEG. Our 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 get your benefits, and to know what your out of pocket expenses would be.
What if I have to cancel my VEEG?
Please notify the Epilepsy Center at 206-320-3492 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 9-East Nurses Station at Swedish First Hill at 206-215-3409.