Preparation for an electroencephalogram (EEG) for brain wave test
Published: May 28, 2013
An electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain. One of the main purposes for an EEG is to help with the diagnosis of epilepsy and to find out what type of seizures you may be having.
Most medical procedures are terrifying to many adults and children. We often have no clue about what to expect and as a result our anxiety levels are usually sky-high resulting in our being nearly paralyzed by fear or extremely restless and screaming due to panic. This situation is counterproductive and can result in the patient and family members becoming extremely frustrated, the neurodiagnostic technologist working much harder than necessary and at times an inadequate study that has resulted in a waste of time and money.
Ignorance is not bliss
It is always smart and prudent to know the important things, so that not only do you look smart to others but you are actually smart. A knowledge of what an EEG is, what to expect and how it is performed, is key to keep everyone’s anxiety and frustration down which leads to a non-traumatic, relatively pleasant experience. The following FYI (for your information) should be extremely helpful in the future.
Remember that all patients (in-patient or out-patient) should have a referral request that includes what type of EEG is required (e.g. routine, emergency, prolonged 24-hour monitoring, ambulatory, video or brain death protocol studies) and its purpose. The prerequisites prior to the EEG being performed are as follows:
• Patient or relative should first be informed of the procedure.
• Current medications are continued unless otherwise indicated (e.g. brain death protocol).
• The patient’s hair is checked for braids or weaves which, if necessary, should be taken out by the patient, relative or healthcare provider.
• Hair should be shampooed or alcohol-sponged and free of excess oil.
• Ensure name band identification is present.
Outside clinic or office
• Current medication is continued as prescribed.
• Breakfast is eaten as normal.
• No sweet cookies, coffee or tea with caffeine.
• Patient’s hair should be shampooed and dried – free of grease, dressing, ribbons etc.
• Regular clothing should be worn.
• No earrings or necklaces.
Children up to seven years old
• Bring bottle or any items (toys) to help keep the child calm until test is completed or until the electrodes are applied and secured.
Once the above is fulfilled, then our neurodiagnostic technologists perform the EEG in a smooth and efficient manner, thus ensuring a good recording is obtained. A good recording is an essential component needed for accurate clinical diagnosis.
All EEG procedures require a referral from a physician before an appointment is scheduled with the EEG department or technologist. The procedure is then completed in four basic steps — preparation, recording, clean up and report generation.
The patient should be assured that the EEG procedure is painless. First the patient’s head is measured using a china marker. Then, everywhere that there is an x-mark that area is then cleaned with skin prep and a recording electrode will be applied with conduction paste. The patient’s head is then wrapped, to keep the electrodes from coming off during the recording.
The recording is performed with a couple of activation procedures. One is photic stimulation, where we flash a strobe light at various speeds with the patient’s eyes closed. The other activation procedure is hyperventilation. The patient is asked to take deep breaths with their mouth open at a relatively slow pace for three minutes. The routine EEG recording is performed for a minimum of 20 minutes, but not exceeding 45 minutes.
At the end of study the electrodes are taken off and the patient’s head is cleaned. It is recommended that the head be shampooed later to remove any excess paste left over during the procedure.
The information of the study is analyzed by a physician specially trained such as a neurologist or neurophysiologist and a report is generated. This information is then sent to the patient’s referring physician who along with the relevant clinical history, examination and other information will make a management decision. This decision is discussed with the patient and/or his relatives (as most patients or their family do not have a complete grasp of all underlying medical issues that can impact outcome) and then the appropriate treatment is implemented.
The referring physician has the critical role of educating and informing their patients or their designate/guardian about the EEG results and what it means, since only then can they make a logical decision about their own health.
• Zulena Rolle-Baptiste is an EEG technician at Doctors Hospital.