Kids Health Info

Video EEG monitoring VEM

  • Video EEG monitoring (VEM) is the prolonged, simultaneous recording of a child's behaviour and EEG (electroencephalogram, or the measurement of electrical activity of the brain). This is done with special equipment that captures the EEG, video and audio onto a computer so that it can be carefully studied.


    Why is VEM performed?

    VEM is performed to:
    • distinguish real epileptic seizures from episodes that may mimic epileptic seizures
    • characterise the type or types of seizures that your child is having
    • localise the part of the brain where your child’s seizures begin


    Where is VEM performed?

    VEM is performed in the Epilepsy Monitoring Unit on the Cockatoo Ward at The Royal Children's Hospital, where children with neurological and neurosurgical conditions are nursed. 


    How long does VEM take?

    Children are admitted for a minimum of one night and a maximum of five days (Monday – Friday), depending on the frequency of their seizures. We would generally want to record two or three typical events while your child is admitted. 

    The epilepsy nurse specialist will liaise with families regarding the admission date for VEM to occur and discuss the process for admission. While we will always try to ensure the VEM occurs on the scheduled day, sometimes delays may occur or your child’s VEM may need to be rescheduled. The hospital bed manager will call you on the morning of admission to confirm that a bed is available and let you know when to arrive. Families may be required to wait in the parent resource room until a ward bed is free.


    How are the electrodes applied and removed?

    The EEG electrodes are placed on your child’s scalp using a special glue that makes sure the electrodes remain in place. Some young children find the smell of the glue unpleasant or the noise of the air dryer disturbing.

    The electrodes are attached on the first day of monitoring and will remain attached until VEM is finished. 

    The electrodes are connected to a small recording unit which is contained in a soft pouch that is worn around the waist. 

    Children quickly become accustomed to the electrodes on their head and the recording equipment around their waist. They do not experience any difficulty with sleep.

    A special solvent is used to remove the glue when the VEM 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 combings to remove it all. 


    What do children do during VEM?

    Children need to stay in a designated area of their room, in constant view of the camera. 

    Toys, books, battery operated games, iPods and iPads with no active WiFi or bluetooth are allowed during VEM.

    For school age children, we recommend bringing school work to try and mimic their normal daytime activity.

    Children will be frequently observed during the day and night by the nursing staff. Children may have continuous heart rate monitoring with a finger probe whilst asleep.


    What is the parent or carer role during VEM?

    • You’ll need to stay with your child at all times. Ideally two parents or carers should be available to take turns sitting with your child, however only one person is allowed to stay overnight.
    • You need to be familiar with your child's seizures to identify when a seizure occurs.
    • When a seizure occurs, you need to press a specific button and write down details of the seizure.  You will be given a full explanation about how to do this.
    • You can help keep your child occupied and ensure that they stay within the camera zone. 


    What about medication?

    Your child’s medications need to be brought into hospital to ensure that the correct medicine and dose is prescribed during VEM.

    Sometimes a child’s antiepileptic medication is reduced prior to admission or during the admission, to cause seizures to occur. Your child's neurologist will discuss this prior to admission.

    Some children who have their medications reduced in hospital have stronger or more frequent seizures than usual. Occasionally, intravenous (IV, or a drip) medication is needed to stop these prolonged seizures.

    Some children will have an intravenous cannula (IV) inserted to make it easier to give medication and fluids.


    What about hair care before VEM?

    To help reduce the amount of natural oils in your child’s hair and make it easier for the EEG electrodes to be attached, it is important to thoroughly wash the hair the night before admission.


    What to wear during VEM

    During VEM, your child should wear comfortable clothing that can be easily changed without needing to take it over the head. Clothing that buttons up in the front is best.

    Please bring cotton clothes for your child to wear. Nylon and satin tops should not be worn because they produce static electricity which affects the VEM equipment.


    Can other children attend?

    Alternate care for siblings must be arranged for the duration of your child’s VEM. No siblings can stay at the hospital overnight.

    As other sick children are being nursed in the ward, it is not appropriate for siblings and friends to visit for long periods. However, brief visits are encouraged.


    What happens if seizures change or decrease prior to VEM?

    Your child needs to be having typical seizure episodes regularly so that they can be recorded during the planned admission for VEM.

    If your child’s seizures change or occur less often, you will need to contact the neurologist or epilepsy nurse specialist to discuss whether VEM is still appropriate. Sometimes medication will be reduced or the VEM admission will be rescheduled.


    What about the results?

    The information gathered during VEM needs to be reviewed by a neurologist, and reports are generally available in the following weeks. A report will be sent to your child’s neurologist. An appointment for results and follow-up will be arranged before your child is discharged.


    Key points to remember:

    • Wash your child's hair the night before.
    • Bring button up, cotton clothing to wear.
    • Typical seizures must be occurring frequently.
    • Contact the epilepsy nurse specialist if seizures are not occurring frequently.
    • Arrange child-minding for your other children.
    • Wait for a phone call from the hospital bed manager before leaving home on the morning of the planned admission.


    For more information:

    Contact the Epilepsy Monitoring Unit
    T: (03) 9345 6909

    Contact the epilepsy nurse specialist
    T: (03) 9345 5639 or 9345 7926

    Visit the Neurology website:  www.rch.org.au/neurology/

    Kids Health Info factsheet:  Electroencephalography (EEG)

    Epilepsy Foundation of Victoria:  www.epinet.org.au

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.