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SUNY Downstate Medical Center

Comprehensive Epilepsy Center

Procedures

EEG

An electroencephalogram (EEG) is a brain wave test that records the electrical activity of the brain.  The test is similar to the ECG (electrocardiogram) that records the electrical activity of the heart. It is used to diagnose brain disorders, especially epilepsy.

Other reasons to have an EEG would be for helping to diagnose or treat:

  • Seizure disorders
  • Head Trauma or Injury
  • Inflammation of the brain (encephalitis)
  • Stroke
  • Dementia or Altered Mental Status
  • Brain Dysfunction (encephalopathy)
  • An EEG has no risks and is virtually painless. 

Ambulatory EEG

An electroencephalogram (EEG) is a brain wave test that records the electrical activity of the brain. An ambulatory EEG is a prolonged EEG that lasts for 1, 2 or 3 days. The ambulatory EEG allows recording brain activity during your normal activity, during overnight sleep and in your own environment.

Video-EEG Monitoring

This procedure is an electroencephalogram (EEG) with video and audio occurring in the hospital setting for a minimum of 24 hours.  The purpose is to be able to see what is happening when you have a seizure, spell or event and compare the video to what the EEG records simultaneously. vEEG is the standard for identification of seizures versus other events and to pinpoint brain areas where seizures may be initiating from to guide treatment, medication management and pre-surgical evaluation. There are no risks to vEEG in general.  

Wada Procedure / Intracarotid Amobarbital Procedure

The Wada test (named after Dr. Juhn Wada), also known as the intracarotid amobarbital procedure, is an important part of the pre-surgical evaluation in patients being considered for epilepsy surgery. It is especially important in patients with temporal lobe epilepsy. The main purposes of the Wada test are to determine if the right or left brain is dominant for language abilities, and to assess memory function on both sides of the brain. Because the test includes angiography it also provides a very accurate picture of blood vessels in the brain, which can help guide future brain surgery. The results of the test help the epilepsy team determine a surgical approach that minimizes the chances that language or memory will be affected by the epilepsy surgery.

To read more details about the WADA test, including how to prepare for the test, please visit the WADA webpage.

MRI

An MRI is a test that provides pictures of the inside of the body. A strong magnetic field is used to form these pictures, which is less harmful than X-rays and CAT scans. In patients with seizures, MRI images of the brain can sometimes show the cause of the seizures, such as a stroke, infection, tumor or abnormal brain tissue. By locating abnormal or damaged brain tissue, the MRI images can help pinpoint where in the brain seizures start, and surgeons may later be able to remove the damage and stop the seizures.

To read more details about MRI, including how to prepare for the procedure, please visit the MRI webpage.

Intracranial Monitoring

Intracranial monitoring refers to video-EEG monitoring where the EEG electrodes are placed inside the skull by a specially trained epilepsy neurosurgeon. The electrode placement is performed in the operating room with the patient asleep under general anesthesia. Typically, a series of electrodes are placed over the region or regions where seizures are thought to originate. After recovery from the surgery, the patient undergoes video-EEG monitoring in the epilepsy monitoring unit or the intensive care unit.

To read more details about intracranial monitoring, including how to prepare for the procedure, please visit the intracranial monitoring webpage.

Neuropsychological Testing

Information from neuropsychological testing is used for diagnosis and treatment planning. In patients who are candidates for epilepsy surgery, neuropsychological testing can help determine which areas of the brain have been affected by seizure activity.

To read more details about neuropsychological testing, including how to prepare for the procedure, please visit the neuropsychological testing webpage.

Epilepsy Surgery

Most people with epilepsy can live seizure-free lives by taking one or two anti-epileptic medications. Unfortunately, about 1 out of 3 people with epilepsy continues to have seizures, despite taking multiple drugs. However, there is still hope for these patients, because some can become free of seizures with another treatment: epilepsy surgery.

To read more details about epilepsy surgery, including how to prepare for the procedure, please visit the epilepsy surgery webpage.

 

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