Ambulatory EEG
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What is ambulatory EEG monitoring?
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pdf of brochure - Why is ambulatory EEG monitoring performed?
- What does ambulatory EEG monitoring involve for the child and parent/carer?
- How long does ambulatory EEG monitoring take?
- Hair care before ambulatory EEG monitoring
- What to wear during ambulatory EEG monitoring
- Can we bring other children into the EEG department?
- Is ambulatory EEG monitoring uncomfortable of painful?
- Where do I go?
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What is ambulatory EEG monitoring?
Ambulatory EEG monitoring is the recording of EEG brain wave activity away from the hospital. eg. while the child is at home or at school.
EEG is recorded to a CF card on a portable, battery-operated device, which is kept in a belt worn by the child. The device is called a Siesta unit and is made by Compumedics Australia.
Why is ambulatory EEG monitoring performed?
The main reasons children undergo ambulatory EEG monitoring are:
- To distinguish non-epileptic from epileptic turns in situations where the child cannot be confined to a bed for inpatient or outpatient video EEG monitoring
- To obtain an overnight, natural sleep recording
- To capture events that are situational eg. only occur at home or at school
Ambulatory and video-EEG monitoring are specialised investigations that are requested by neurologists following specialist consultation. Characterisation and localisation of seizures in children with uncontrolled epilepsy are best done with simultaneous video-EEG monitoring, where the video picture of seizures is also recorded.
What does ambulatory EEG monitoring involve for the child and parent/carer?
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The child can attend kindergarten or school, move around freely, and sleep at home with the unit attached.
To protect equipment, children must not run around, play sport, or play on gym equipment or in sand pits. Bathing, showering and hair washing are not allowed.
The parent /caregiver needs to supervise the child and is required to keep a diary of episodes. The recording unit has an event button and a time display for indicating when episodes or other incidents occur. There is no video recording involved, unless a parent takes a separate home video recording. For sleep recordings, the parent/caregiver indicates when the child goes to sleep and wakes.
How long does ambulatory EEG monitoring take to set up?
Parents need to allow approximately an hour and a half for the monitoring equipment to be set up. The child needs to attend the EEG Department the following day, for the EEG information to be downloaded onto a computer. This takes half an hour. If the EEG information is satisfactory and examples of typical events have been recorded, the electrodes can be removed. This takes approximately 45 minutes.
If an unsatisfactory recording has resulted, or typical events did not occur, ambulatory monitoring can be continued for another day (up to a maximum of 5 days and 4 nights). This involves returning to the EEG Department daily or second daily for the scalp electrodes to be checked and the battery changed.
Hair care before ambulatory EEG monitoring
To help reduce the amount of natural oil in the hair and aid EEG electrode application, it is important to thoroughly wash your childs hair the night before monitoring is setup.
What to wear during ambulatory EEG monitoring
It is preferable that your child wears comfortable clothing that can be easily changed, without taking it over the head. Clothing that buttons up in the front is best. Nylon and satin tops produce static electricity, which affects the EEG recording, and should therefore not be worn. Natural fibres such as cotton are preferred.
Can we bring other children into the EEG department?
We strongly encourage you to organise alternative care arrangements for siblings, as you will be required to assist us support your child during electrode application and set up.
Is ambulatory EEG monitoring uncomfortable of painful?
As for routine EEG, electrodes are place on the scalp, but special glue is used to keep them in place. Some young children find the smell of the glue unpleasant or the noise of the hair dyer disturbing.
The electrodes are attached on the first day of monitoring and remain in place until monitoring is finished. Children quickly become accustomed to the electrodes on their head and usually do not experience any difficulty with sleep.
A special solvent is used to remove the glue from the electrodes when the monitoring is finished. Some children find this procedure uncomfortable. Fragments of glue and dried electrode gel may remain in the hair and it may take several hair washes and combs to remove it all. If your child has long hair please bring along a hairbrush.
Where do I go?
Children having Ambulatory EEG Monitoring are set up by the technologist in the EEG Department of the Children's Neuroscience Centre located on the 8th floor of the main building at the Royal Childrens Hospital.
Once the scalp electrodes are in place, equipment connected and instructions given, you and your child can leave the hospital to return the following day. The time to return will be organised by the EEG technologist.
For more information about ambulatory EEG monitoring
Contact the Children's Epilepsy Program
Children's Neuroscience Centre
Department of Neurology (EEG Department)
Royal Childrens Hospital
Tel (03) 9345 5661
Ms Susan Watson - EEG Technologist in Charge (Ambulatory Monitoring)
Tel (03) 9345 5661
Ms Kathryn Santamaria & Jill Bicknell - Epilepsy Nurse Specialists
Tel (03) 9345 7926/5639