Video-EEG Monitoring (Long-Term EEG Telemetry)

Video-EEG monitoring records your brain's electrical activity and a synchronised video of you continuously, for a period from one to several days, usually in a hospital room. The purpose is to capture your typical attacks so that doctors can see exactly what happens in the brain and the body simultaneously.

It is the most reliable way to establish whether events are epileptic, which type of seizures you have and where they begin. Around one in four or five people referred with drug-resistant epilepsy turn out to have a different diagnosis. Its limitation is straightforward: if no typical event happens during the stay, the result may be inconclusive.

What Video-EEG Monitoring (Long-Term EEG Telemetry) shows

During a seizure, the EEG shows where the abnormal rhythm starts (focal onset, from a temporal, frontal or other region) or whether it begins across both hemispheres at once (generalised onset), and how it spreads. The video shows the corresponding behaviour: staring, automatisms, head turning, stiffening or jerking, and their sequence and side, which also help localise the origin. Between seizures the recording captures spikes and sharp waves, including in sleep. If an attack occurs with no EEG change of the expected type, this points to functional (dissociative) seizures, fainting, sleep disorders or movement disorders; ECG recorded at the same time can reveal heart rhythm causes. For surgical planning, the findings are combined with MRI, PET and neuropsychological testing.

When Video-EEG Monitoring (Long-Term EEG Telemetry) is recommended

• Seizures that continue despite two or more appropriate medicines
• Uncertainty whether attacks are epileptic, functional, syncopal or sleep-related
• Pre-surgical evaluation to locate the seizure onset zone
• Classifying the seizure type when it affects the choice of medicine
• Suspected frequent subtle or night-time seizures, or counting seizures accurately
• Children with possible epileptic spasms or epileptic encephalopathy

Limits and situations where another test is better:

• People whose events are rare, such as a few times a year, because capture is unlikely even in a week
• A first seizure or well-controlled epilepsy, where a routine or sleep-deprived EEG is enough
• Scalp electrodes can miss deep or very small seizure sources; selected surgical candidates go on to invasive stereo-EEG
• It is a planned investigation, not a way to manage seizure emergencies

How to prepare

• Wash your hair the night before and avoid oils, gels and sprays
• Bring loose tops that button or zip at the front, since nothing can be pulled over the head
• Bring a list of all your medicines with doses, and a diary or phone videos of your typical events
• Medicines may be reduced in hospital to provoke seizures; never reduce them yourself beforehand
• Bring books, a tablet and chargers; a relative who knows your attacks may be asked to stay, and this is expected for children
• Arrange not to drive yourself home, since drug reduction can leave you at risk of seizures

What happens during the test

A technologist measures your head and glues 21 to 32 small electrodes to the scalp with collodion or paste, which takes about an hour. The leads run to a small box worn in a pouch, giving you some freedom to move within the room, in view of the camera. You or your companion press an event button whenever an attack begins, and nurses come in to test your awareness, speech and memory during the event. To encourage seizures, the team may reduce medication, keep you awake late, or use flashing lights and deep breathing. Safety measures include padded bed rails, supervised bathroom visits, an intravenous cannula and rescue medication. The usual stay is 3 to 5 days, sometimes up to 7 or more.

Results and next steps

An epileptologist reviews all events and samples of the background recording. Preliminary conclusions are often shared before you leave hospital, and a full written report follows in 1 to 2 weeks. Possible next steps are changing medication, confirming a non-epileptic diagnosis and referral for the appropriate therapy, or discussion at a multidisciplinary epilepsy surgery conference. Your medicines are returned to a safe dose before discharge.

• Test time: 3 to 7 days, continuous
• Results ready: Preliminary at discharge; full report in 1 to 2 weeks
• Back to everyday activity: 1 to 2 days after medication is restored

Safety and risks

• Seizure clusters, prolonged seizures or status epilepticus when medication is reduced, treated promptly on the unit
• Injury or falls during seizures
• Post-ictal confusion or, rarely, psychosis in the days after a cluster
• Scalp irritation or small sores from electrodes and glue
• No typical event captured, giving an inconclusive result

Arranging Video-EEG Monitoring (Long-Term EEG Telemetry) in Türkiye

A planned admission of 3 to 7 days suits a visit well, particularly when you need a clear diagnosis or a surgical evaluation that is not available near home. Allow a few extra days, because seizures do not happen on schedule, plus 1 to 2 days for medication to be restored before you fly. Bring your MRI images and previous EEGs. Ongoing epilepsy care remains with your neurologist at home.

Send your previous reports and the question you want answered and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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