Tuesday, September 27, 2022

How To Sleep With An Ambulatory Eeg

How An Eeg Is Carried Out

Trex HD Video Ambulatory Setup

There are several different ways an EEG recording can be taken. The clinical neurophysiologist will explain the procedure to you and can answer any questions you have.

You’ll also be asked whether you give permission for the various parts of the test to be carried out.

Before the test starts, your scalp will be cleaned and about 20 small sensors called electrodes will be attached using a special glue or paste. These are connected by wires to an EEG recording machine.

Routine EEG recordings usually take 20 to 40 minutes, although a typical appointment will last about an hour, including some preparation time at the beginning and some time at the end.

Other types of EEG recording may take longer.

What Are The Advantages Of The Inpatient Setting

  • Probably the single most compelling reason for the inpatient setting is the ability to reduce medications safely . In the hospital, people have an intravenous line or IV placed so medications can be given quickly to prevent or treat emergency situations.
  • The second major advantage is that the inpatient unit is a controlled environment. The chance that the person will be on camera at the time of the event/seizure is much higher than in the ambulatory setting.
  • The ability to address technical problems with technologists during recording is better, since technologists are on site.
  • Activation procedures, such as hyperventilation, photic stimulation, sleep deprivation, and suggestion, are easily performed.

When An Eeg Is Used

An EEG can be used to help diagnose and monitor a number of conditions affecting the brain.

It may help identify the cause of certain symptoms such as seizures or memory problems or find out more about a condition you’ve already been diagnosed with.

The main use of an EEG is to detect and investigate epilepsy, a condition that causes repeated seizures. An EEG will help your doctor identify the type of epilepsy you have, what may be triggering your seizures and how best to treat you.

Less often, an EEG may be used to investigate other problems, such as dementia, head injuries, brain tumours, encephalitis and sleep disorders, such as obstructive sleep apnoea.

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Sleeping Position For Ambulatory Eeg

As your head may be wrapped to take care of all the sensors and wires on your head, it will allows you to sleep in your favorite sleeping position. Sleep on your side or on your back, the important thing is to keep the recording equipment above your head so that it does not get under you while sleeping. You can use a hanger over your head or try to keep it as away as possible.

Analysis Methods For Ambulatory Eeg

Electroencephalogram (EEG)

Its clear that collecting EEG data from a dynamically changing environment over a period of time presents a challenge. Noise from a range of sources is easily introduced.

The first step in data analysis is often visual inspection it could be that the only data that is impacted by noise is present in moments of the experiment that arent being investigated . These noisy parts of the data are simply removed.

If noise persists in the important parts of the data, the next step is to apply filtering. Filtering is particularly effective if noise is present in very low or very high frequencies frequencies which are not usually of interest to the study.

In that case, a high-pass filter or low-pass filter can be applied to the data. For instance, if the research question concerns alpha activity , high frequency noise can often safely be removed using a low-pass filter.

Are artifacts being taken care of within iMotions? Within iMotions, it is important to distinguish between working with raw data or with metrics. Users who use iMotions as a recording tool, export the raw data for further processing in specialized EEG software, such as EEGLAB, Fieldtrip, BCILAB, BESA or Cartool.

As such, the user is in full control of the signal processing applied to the data. Other users work with metrics, which are either provided by the hardware or by iMotions . In that case, decontamination of the signal is already taken care of in the calculation of the metrics.

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What Do I Need To Do Before My Test

  • Assemble enough comfortable, appropriate clothes to wear. Most patients wear street clothes or a sweat suit during the day and warm pajamas and socks at night. Remember that the tops should button and be loose fitting.
  • Bathe and wash your hair well.Do not leave any hair products in your hair and remove any braids or hair extensions. This will facilitate comfortable placement of the electrodes.

Will An Eeg Test Cause Me To Have A Seizure

Theres a very small risk that you could have a seizure during an EEG test. This could be caused by looking at a flashing light or breathing deeply. These activities are usually part of the test. You will be closely monitored and medical professionals will be there to help if you do have a seizure.

Your doctor might ask you to have less sleep than usual before you have some types of EEG tests. This is done to increase the chances of catching abnormal activity during the test. This might also increase the risk that you would have a seizure around the time of having the test.

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Why Do I Need One

The brains electrical activity fluctuates from second to second, but routine EEGs provide only a 20- to 40-minute sample of this activity. If epilepsy waves occur in your brain only once every 3 or 4 hours, or if they only happen at certain times of day, a regular EEG might not record them.

To record seizure activity, a longer EEG recording with times that you are both awake and asleep may be needed. When this test is done at home, it’s called an ambulatory EEG.

An ambulatory EEG may be done if you continue to have seizures after trying various seizure medications. The testing can either confirm the diagnosis of epilepsy or find that epilepsy waves are not causing the seizures. Ambulatory EEG monitoring is generally done at a specialized epilepsy center.

What Is Ambulatory Eeg Monitoring

My Ambulatory EEG

EEG is the abbreviation for electroencephalography. The electroencephalograph is a machine that translates the electrical activity of the brain into a series of wavy lines on a computer called the EEG record.

An EEG measures the electrical activity of the brain, sometimes referred to as brain waves.This test is performed to see how the different parts of your brain function. It records a graph of your brain waves.

Digital analysis is a procedure that can give additional information about any problems that may be found.

Analysis and examination of the data obtained allows your doctor to see one of the many ways that your brain functions. EEG is not a treatment of any kind. No electricity is transferred to your brain. The EEG only detects activity in the brain.

If you have a seizure during the test, you should behave as you normally would during a spell / seizure. Family and friends should follow your usual spell / seizure first aid or emergency procedures.

It can tell us what may be causing your episodes and help with deciding the best treatment for you.

The doctor can see abnormal activity as well as sleep stages during your EEG.

At the end of the time period you will return to the EEG clinic to have the electrodes removed and then the information gathered or collected will be downloaded to the computer for analysis.

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What Are The Reasons For Ambulatory Eeg

Ambulatory EEG is usually carried out for the following reasons:

  • Epilepsy detection and monitoring
  • Sleep studies
  • Research of natural behavior

The former two examples are principally for medical reasons the application of ambulatory methods is done so in order to detect or measure aberrant neurological activity throughout the day. The latter two are more concerned with understanding how brain processes change in a normal population over time .

Below, we will specifically talk about how the brain processes occurring with natural behavior can be measured using ambulatory EEG, and the common pitfalls that occur with data collection and analysis.

Electrode Application For Human Eeg Studies

This protocol describes EEG electrode application using a 10-20 electrode system . Distinct landmarks are identified on the head and electrodes are placed at 10% or 20% intervals of the distance between the landmarks . The number of electrodes used will depend on the purpose of the study. The 2007 AASM visual scoring rules recommend a frontal electrode for best detecting K-complexes, a central electrode for spindles, and an occipital electrode for alpha waves . This section describes placement of a frontal electrode Fz, a central electrode C4, and an occipital electrode O1. Backup electrodes at F4, C3, Cz, and O2 are recommended in case an electrode falls off. Signals from the EEG electrodes are referred to an electrode placed over the contralateral mastoid. Many recording systems use a separate reference electrode to which all signals are initially referred. Electrode pairs such as C3-A2 are obtained by subtraction, i.e. C3-ref minus A2-ref = C3-A2. The protocol also describes application of ground and reference electrodes, electro-occulogram electrodes, and chin electromyogram electrodes.

Head measurements and electrode placement according to the 10-20 electrode placement system . The longitudinal line from the nasion to inion is divided into 10% and 20% segments. Distances along the transverse line and the circumference are not to scale because the 3-dimensional head is drawn in 2-dimensional profile. Approximate locations of Fz, C3, O1, and A1 are indicated.

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Check Electrode Impedance And Complete Subject Preparation

The purpose of the alcohol wiping, abrading, and the electrolyte gel and paste is to provide good conductance between the electrode and the skin. If impedance is high the signal quality will be poor and may be corrupted by electrical line noise . The following procedure ensures that electrodes were applied correctly.

Preparing For An Ambulatory Eeg

Ambulatory EEG setup at Nemours Childrens Hospital

Why do I need Ambulatory EEG Monitoring?

Epilepsy is a disease of the brain caused by abnormal electrical activity. Ambulatory EEG monitoring enables your doctor to observe your EEG over a prolonged period of time. Ambulatory monitoring can help diagnose your seizure type and provides important information regarding the best treatment for your seizures.

What will happen when I am set up for monitoring?

Placement of the EEG wires for monitoring

EEG wires will be attached to your head with a special glue so that the electrodes will stay attached for several days. Sometimes, the electrodes can cause some itching to occur and you can take medication to help the itching. Do not scratch your head with the electrodes in place. Benadryl 25 mg to 50 mg can be used for itching. This can be obtained over the counter at your local pharmacy.

Food

Please do not eat potato chips or other snack foods or chew gum, since this will interfere with the EEG – it generates a lot of noise on the graph which makes it impossible to detect anything else.

Clothing

You should wear comfortable clothing while your ambulatory EEG is being performed. Sweat pants and a loose fitting top with buttons down the front are suggested. Tight fitting sleeves and pull over tops will not be permitted. Do not attempt to pull a shirt or other clothing over your head during the ambulatory EEG. The electrodes may become dislodged and the quality of the recording will be affected.

What do I need to do before my test?

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What Is The Equipment Like

RSC uses lightweight equipment, and patients are free to move about their homes without restrictions. It is important that the patient follows the instructions provided by the technician to avoid compromising the results of the study. The equipment weighs approximately 1.2 lbs and is smaller than an average tablet.

Will I Have To Give My Consent For An Eeg Test To Be Done

You will usually have to give your consent to having an EEG test done. This is because it is important that you are aware of why the test is done and of its risks, however small they might be. A video recording is usually recorded as part of the EEG test. Your consent will also be needed for this.

If you give your consent, but then change your mind, you can withdraw your consent at any time. The NICE guidelines say you should be given information on the reasons for tests, their results and meaning, the reasons for of specific investigations, and how they will be carried out.

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Will I Have To Have More Than One Eeg Test

There are several ways an EEG test can be done. And there are several reasons why you might be asked to have further EEGs.

  • If you have an EEG test that doesnt show any unusual electrical activity in your brain, your doctor might ask you to have another
  • It can be helpful, if possible, to have an EEG test at times when you are more likely to have a seizure. For example, this might be early in the morning. For some women, it might be around the time of having a period

Keep Your Log Sheet Near To Your Reach

72 hour ambulatory eeg experience and vlog

As it is important to collect any abnormal sign that you may feel during the ambulatory eeg. Your doctor may have provided you a log sheet on which you have to write the sign and the time. Keeping it near to your reach can make a big difference because it can help you stay in bed and also write down any sign or symptom without getting out of your bed.

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What Does An Eeg Test Do

An electroencephalogram records activity in the brain. Your brain constantly produces tiny electrical signals. During an EEG test, small sensors, called electrodes, are placed on your scalp. The electrodes are connected by wires to an EEG machine. Electrodes are attached using a special paste glue or paste. After the electrodes are removed, you may still have a lot of glue in your hair. Hair conditioner can help to remove the glue afterwards.

The electrodes pick up the electrical signals from your brain and record them on a computer. They only pick up the electrical signals. They dont interfere with your brain and they dont cause you any pain.

The electrical signals look like wavy lines that show your brainwave patterns. The EEG test can only show your brainwave patterns at the time the test is carried out. At different times, your brainwave patterns may be different.

A highly trained specialist, called a clinical neurophysiologist, can recognise if your EEG test shows a brainwave pattern that is different to most other people. Some of these patterns point to a strong possibility of epilepsy.

Cost And Health Insurance

With health insurance, an EEG can be covered as long as it is considered medically necessary and corresponds to the terms of your policy. Of course, you may be responsible for a copayment for the procedure or visit, especially if you have not met your annual deductible.

The estimated national average for the cost of a sleep-deprived EEG is $930, however, the cost can vary depending on where the procedure takes place, your state of residence, and other factors. Generally, extended EEGs, unlike standard EEGs that cost from around $200 to $800, may cost between $1,000 and $3,000, or more.

Some hospitals may offer discounts of up to 30 percent for patients who don’t have health insurance or who pay out-of-pocket for an EEG. Be sure to ask. Try to verify your financial responsibility prior to the testing if this is a concern.

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Figure 3 Shows Eeg Samples With Common Artifacts

Common EEG artifacts. An unstable rolling baseline is commonly called a sweat artifact whether or not it is caused by the subject sweating. The 60-Hz artifact is seen as a dark buzz riding on top of the normal EEG. When expanded , 60 waves per second can be seen. Movement artifacts are characterized by a combination of high-frequency EMG and a low-frequency component caused by cable sway. Regular periodic bursts of high-frequency EMG activity are seen on the EEG trace during teeth grinding. Pulse artifacts are typically recorded by A1 or A2 electrodes and are most apparent during low amplitude EEG in REM sleep.

Why Do I Need An In

Electroencephalogram (EEG): Uses, Procedure, Results

The brains electrical activity fluctuates from second to second, and routine EEGs provide only a 20-40 minute sample of this activity. If epilepsy waves occur in your brain only once every 3 or 4 hours or days, or if they happen only after an hour of sleep, for instance, a routine EEG will usually be normal.

As a result, the doctor may want to see a longer recording that includes prolonged periods when you are both awake and asleep. This kind of recording is called an ambulatory EEG or a prolonged in-home video EEG.

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What Do I Need To Know About An Ambulatory Electroencephalogram

  • An ambulatory EEG is a test that measures the electrical activity in your brain. The test may last 24 hours or more. The test will start in your healthcare provider’s office and continue in your home. The discs and wires on your head will be connected to a recorder. The recorder is a small box that can be worn on your shoulder or across your waist. Your head may be wrapped with gauze or covered with a cap. The gauze or cap will help hold the discs and wires in place.
  • You may need an ambulatory EEG to diagnose or monitor seizures or sleep disorders. An ambulatory EEG can help healthcare providers decide if treatment should be started, stopped, or changed. You may also need an ambulatory EEG before surgery for epilepsy. This will help your surgeon plan your surgery.

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