Atlas of Ambulatory EEG by Steven C. Schachter MD, Donald L. Schomer, Bernard S. Chang

By Steven C. Schachter MD, Donald L. Schomer, Bernard S. Chang

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Ambulatory EEG Monitoring Inpatient monitoring often entails a long hospitalization and is resourceintense in terms of staffing, hospital facilities, and maintenance of a monitoring unit. Ambulatory monitoring has been developed over the past 20 years and is now comparably reliable to monitoring done in the hospital. [8, 15] Inpatient monitoring is more expensive, but it is not always better. In many cases, ambulatory outpatient EEG monitoring may be preferable, especially when it does not require anticonvulsant reduction.

Most current ambulatory EEG systems are very similar to those used for inpatient units. Ambulatory monitoring was facilitated markedly by the development of lightweight preamplifiers wrapped near the electrodes on the patient’s head that allow amplification without the long wires or cables needed for standard EEGs. [15] These preamplifiers lessen movement artifact. The Clinical Use of Ambulatory EEG Bipolar recording technique allows for a lower signal amplitude suitable for the preamplifiers. For seizure onset localization, 16 or more EEG channels are appropriate.

Reports from monitoring sessions must distinguish clearly what the patient’s symptoms were during the events, what was seen by observers and on video monitoring, and what the EEG recording showed at the same time. With the increased potential for artifacts, the variability of clinical seizure manifestations, and the importance of rendering an accurate diagnosis in the case of seizures and in nonepileptic events, a conservative interpretation of results is appropriate. References 1. , Wilkus R. Long-term monitoring for epilepsy.

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