Long-term Video EEG Monitoring
Long-term Video EEG Monitoring
Long-term Video EEG Monitoring (LTM) is a specialized diagnostic procedure combining continuous EEG recording with synchronized video recording of patient behavior, typically lasting 24 hours to several days.
Key Points
- Gold standard for epilepsy diagnosis and classification
- Simultaneous recording of EEG and clinical behavior
- Essential for pre-surgical epilepsy evaluation
- Helps differentiate epileptic from non-epileptic events
- Valuable for treatment response assessment
Equipment Requirements
- EEG Recording System
- Minimum 32-channel digital EEG
- High sampling rate (≥256 Hz)
- Multiple montage capability
- Continuous impedance monitoring
- Video Recording System
- High-definition cameras
- Day/night recording capability
- Wide-angle coverage
- Pan/tilt/zoom functionality
- Infrared capability for night recording
- Data Storage and Management
- Large-capacity storage systems
- Automated backup systems
- Network integration capability
- HIPAA-compliant security measures
Monitoring Environment
- Room Requirements
- Adequate space for equipment
- Proper lighting control
- Patient safety features
- Emergency response access
- Safety Considerations
- Seizure precautions
- Fall prevention measures
- Emergency call systems
- Continuous nursing supervision
Standard Procedures
- Pre-Recording Setup
- Electrode application using 10-20 system
- Additional electrodes as needed
- Impedance check and documentation
- System calibration
- During Recording
- Regular electrode checks
- Continuous impedance monitoring
- Event documentation
- Medication adjustments if required
- Activation Procedures
- Sleep deprivation
- Hyperventilation
- Photic stimulation
- Activity-specific triggers
Primary Indications
- Epilepsy Evaluation
- Seizure classification
- Frequency quantification
- Nocturnal event characterization
- Treatment response assessment
- Pre-surgical Assessment
- Seizure focus localization
- Ictal onset patterns
- Propagation patterns
- Eloquent cortex mapping
- Differential Diagnosis
- Psychogenic events
- Movement disorders
- Sleep disorders
- Behavioral events
Special Situations
- Status Epilepticus
- Treatment monitoring
- Burst suppression tracking
- Outcome prediction
- Critical Care Monitoring
- Continuous ICU monitoring
- Post-cardiac arrest
- Traumatic brain injury
Analysis Methods
- EEG Analysis
- Background activity assessment
- Interictal abnormalities
- Ictal pattern identification
- Quantitative EEG measures
- Video Analysis
- Clinical semiology
- Behavioral correlates
- Movement patterns
- Consciousness assessment
- Correlation Analysis
- EEG-video synchronization
- Clinical-electrical correlation
- Temporal relationship analysis
Age-Specific Considerations
- Neonates and Infants
- Modified electrode placement
- Special safety precautions
- Parent accommodation
- Feeding schedules
- Children and Adolescents
- Age-appropriate activities
- School arrangements
- Family support systems
- Behavioral management
Special Protocols
- Recording Modifications
- Shorter recording segments
- Frequent electrode checks
- Activity-specific monitoring
- Family involvement
- Safety Measures
- Continuous supervision
- Child-proof environment
- Emergency protocols
- Family education
Report Components
- Technical Information
- Recording duration
- Electrode placement
- Recording parameters
- Technical quality
- Clinical Findings
- Event description
- Behavioral correlates
- Timing and duration
- Triggering factors
- EEG Analysis
- Background activity
- Interictal findings
- Ictal patterns
- State changes
Clinical Correlation
- Diagnostic Conclusions
- Event classification
- Syndrome identification
- Localization information
- Management Recommendations
- Treatment modifications
- Further testing needs
- Safety precautions
- Follow-up planning
