To help diagnose your child's epilepsy, we may perform what's called electroencephalogram (EEG) video telemetry to monitor electrical activity of the brain and record a sampling of a typical seizure or spell.
A standard EEG provides a "snapshot" of electrical activity in your child's brain and runs about 30 minutes. When a standard EEG doesn't provide enough information regarding the source of seizures and where they progress, continuous EEG video telemetry may be performed to monitor electrical activity over an extended period of time.
Each year, we monitor more than 150 children, the majority with uncontrolled epileptic seizures. More than half of our patients are given a new medication plan based on the monitoring results and an improved understanding of the seizures.
Here are some frequently asked questions about EEG video telemetry.
How should I preparel my child for monitoring?
Discussions about the procedure will depend on your child's age. Pre-school children, for example, do best with information a day or two before the event. Older children need more time to talk it over and develop questions. Generally, we believe it's best to give your child as much information as he or she can understand. In addition:
What should we bring to the hospital?
Please bring:
Where do we go when we arrive at UCSF Benioff Children's Hospital?
UCSF Benioff Children's Hospital is located at 505 Parnassus Ave., in San Francisco. For directions, please call (415) 476-2999 or see our map and directions online.
Public parking is located across the street from the hospital. The fee is $2.25 per hour with a maximum $20 for a seven- to 24-hour period. If you stay in the hospital for more than two days, you qualify for a discounted parking rate of $12.50 a day. Please contact the Family Resource coordinator for a discount parking form. The Kezar Stadium parking lot is at 800 Stanyan St. The fee is $13.00 per day.
When you arrive, please check-in at the Admitting Office on the first floor of the hospital near the Emergency Department entrance. After your child is admitted, please go to the sixth floor of the Long wing of the hospital. Check in at the nurses' station and a nurse will show you to your child's room.
How long will my child be in the hospital?
Your child's hospital stay may range from one night to one week, depending on how long it takes to record a sampling of a seizure or spell. It may take several days for a seizure to occur for recording. We may ask you to help your child stay awake overnight since sleep deprivation can help bring on seizure activity. If exercise or fatigue brings on your child’s seizures, we may ask your child to exercise on a padded mat.
We recommend that you, or another family member, stay with your child while in the hospital. A chair that converts into a bed is available in each child's room. The room also contains a telephone, television with VCR and private bathroom. Video games and a play mat are provided upon request. Sitters also are available for brief periods to give you a break. If a caregiver is not available to accompany your child, please let us know so we can make alternate arrangements.
The hospital will provide meals for your child. For parents and others, food is available at the hospital cafeteria and food vendors in Millberry Union, across the street. A small refrigerator and microwave oven also is available on the hospital's sixth floor.
For lodging for other family members, a Family Resource coordinator can provide assistance. Please call (415) 353-2016 for more information.
How is EEG video telemetry performed?
EEG video telemetry occurs in two parts.
EEG Telemetry — Electrodes are glued to your child's scalp to record the brain's electrical activity. To make the glue adhere for this extended period, it is dried with bursts of air from a small air compressor. The air can be loud and startling but is painless.
A computer monitors the EEG recording so that seizure activity is marked and recorded, even if not obvious. This is important for children who have brief seizures or ones that occur during sleep.
Video Telemetry — A camera records your child and allows us to compare what physically occurs during a seizure with what is recorded by the EEG.
The hospital room has a camera mounted on the ceiling at the foot of the bed — or crib depending on your child's age — and a microphone directly over the bed. The camera may be adjusted so your child can move from one area of the room to another. The EEG electrodes are attached to a 20-foot cord so your child can get out of bed and go to the chair, play mat and bathroom.
A black button and a white button, which look like nurse call buttons, are clipped to the padded siderail of your child's bed. Push both buttons as soon as you notice your child is having a seizure or any "strange" feeling. The black button alerts the computer to mark and save what appears on the video and EEG. The white button notifies your nurse to examine your child during and after the seizure.
Your role is important in identifying the seizures since your child may alert you to an oncoming seizure before changes occur on the EEG. Your assistance may enable us to record the entire event.
Your child must stay in his or her room, except when in the playroom during designated hours, to remain within range of the camera. Time in the playroom may vary, depending on availability. In the playroom, your child will be supervised by hospital staff.
Will the electrodes remain attached during the entire hospital stay?
Yes, your child will be "wired" with EEG electrodes during the entire stay. A child life specialist will be aailable to help calm or distract your child when the electrodes are applied. The glue has a strong odor and once dry, it's itchy. We work to help your child adjust to the electrodes.
Wires from the electrodes are connected to a receiver and computer. The electrodes are checked daily by an EEG technician to ensure they're working correctly. Electrodes aren't removed until the testing is complete. Most children find it easiest to wear "tie-in-the-back" hospital pajamas. Your child may wear his or her own pajamas if the top has buttons or a zipper on the front or back.
Your child's hair won't be washed until the electrodes are removed. A special solution is used to remove the electrodes and glue.
Will my child continue to take anti-epileptic medication during the hospital stay?
Your child’s anti-epileptic medicines may be slowly decreased while in the hospital to help bring on a seizure. DO NOT taper your child's medications on your own, unless directed to do so by your doctor. Remember, your child will be under strict medical supervision so there's no need to worry about your child's safety.
A catheter may be inserted in your child's arm, depending on your child's condition, to administer emergency intravenous medicines. If your child has severe or frequent seizures, we can stop them by administering intravenous medicines. The IV is checked daily by a nurse and changed as necessary. A child life specialist will be present as the IV is placed to help your child remain as comfortable as possible.
How are the monitoring results used?
The more accurately we are able to classify your child's seizure type, the better we are able to control the seizures with medication. For children who are having "spells" or behavior changes for unknown reasons, this test can help characterize the episodes. The "spells" may be seizures or may be due to other physical or emotional causes unrelated to epilepsy.
EEG video telemetry helps localize a seizure focus in the brain, which is critical in determining if your child can be treated with surgery. Seizure surgery is most successful when we can identify the precise area in the brain where seizures originate. Prolonged monitoring allows us to record a number of seizures. It may show us that a single area in your child's brain is producing seizures or that more than one area is involved. If the seizures originate in more than one area, the chances for successful surgery decrease considerably. Based on monitoring results, we may recommend additional tests or alternative treatments.
Our team includes a pediatric epileptologist, nurse practitioner, pediatric social worker, neurology fellows, pediatric residents, nurses, EEG technologist and child life specialist. Team members will meet with you and your child daily to discuss your child's monitoring and to ensure you and your child are as comfortable as possible. If further monitoring studies, surgery or participation in an experimental drug trial are good options for your child, each option will be discussed in detail.
Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated April 30, 2012
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
Epilepsy Center
400 Parnassus Ave., Suite A-889
San Francisco, CA 94143
Phone: (415) 353-2437
Fax: (415) 353-3573