Neurology - Home Ambulatory EEG (HAEEG)

Home Ambulatory EEG

Home ambulatory electroencephalogram (HAEEG) refers to an EEG which is recorded over a period of 1-3 days at your own home, with the addition of a video camera. This is set up within the Neurophysiology department and involves coming back each day to download the recorded information, before readying you for the next day. A demonstration on how to use the video camera is provided, as well as a video tutorial which will be emailed to you.

Why is it performed?

HAEEG allows us to monitor your brainwaves over a longer period compared to the routine tests provided in the department. We can also capture this in your normal environment and capture overnight sleep. Video recording is taken to see whether there are any clinical changes, along with EEG changes, if present, and to capture a recording of your typical event(s)/episode(s).

Overall, the HAEEG increases the chances of capturing a typical episode/event(s) and when combined with a clinical history, neurological examination and scan results, it can help to clarify your diagnosis.

How is it performed?

The test will be set up in the neurophysiology department, which can take up to 60 minutes. This involves attaching electrodes (small disks attached to wires) onto the scalp using some paste and using either special glue or a bandage, to keep them in place for the remaining study. Additional wires may be attached to record extra information. The wires will be neatened up and plugged into a box, which will be held by a bag. The recording will be started, and this bag is to be worn for the duration of the recording.

Before leaving, a video demonstration will be given which is to ensure you are well-informed and comfortable using the camera. You will leave the department with a bag holding the box, a briefcase which will be carrying the video camera, and a diary sheet. The EEG will be always recording. However, the video will not record until you set it up and start it at home, following the written instructions for switching it on. We advise you record as much as possible to increase results.

You will be given a diary to complete (times of meals, activities, sleep etc) and to record any events/episodes that you are aware of. There is also a red button for you to press at these times as soon as you can.

You will be required to return to the neurophysiology department with the bag and briefcase (with camera) after 24hours to allow for download and checking the leads have remained in place. You will then be prepared for the next 24hours. This will take around 20 minutes.

When arriving home

Plug the video camera into the mains power to keep it charging and turned on. Follow the instructions for switching the video camera on and begin recording.

Ideally the camera needs to be placed in a safe place, positioned higher up than yourself, if possible, away from children and pets.

You should be clearly visible on camera, and it is important that the settings are not tampered with while it is recording. When you go to bed, move the video camera to your bedroom to record whilst you sleep. Please follow the written instructions to begin recording again and press the INFRA RED button at night.

End of the HAEEG

Ensure you bring all the equipment upon returning, as well as the diary sheet which is provided. The physiologist will end the recording and remove the electrodes. If glue was used, this will be removed using acetone and oil however some residue may remain. In this instance use conditioner, oil and a comb to fully remove it, and then wash your hair.

The test is analysed by the physiologist and a consultant Neurophysiologist. A full report will be written and sent to the referring consultant, who will in turn be in touch with you.  Results are not available immediately after the test.

Important factors to consider during the test

• Do not shower or bathe during the monitoring
• Ensure the equipment does not get wet
• It will be your responsibility to inform your family or guests that they may be recorded in pictures and sound if they are in view of, or in earshot of the camera
• You should behave naturally while at home but remember that all behaviours may be seen by the physiologist/consultant when they review the video
• Part of your written consent (see below) is that you agree for staff members involved with your care to be allowed to view the video. The risk for you and your family members/guests are that somebody on camera may be recognised by a member of staff

This is a piece of medical equipment and is your responsibility from when it leaves the Neurophysiology department until it returns to the Neurophysiology department. This includes travelling to and from your home and the time it remains in your home.

Side effects/Risks

HAEEG is a painless procedure with no side effects. If you have sensitive skin you may feel some irritation where the electrodes will be placed.

The briefcase carrying the video camera may be considered heavy for some (approx. 5 kg). The case does not have wheels. It is advisable that someone comes with you to either carry the case or collect you with the case just outside the department. Please let us know if this will be a problem before you come for the test.

If the video camera is knocked over, there may be a risk of injury to anyone/anything situated nearby.

Consent

We would like to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form agreeing to have the EEG recording with video and sound. You should understand what is involved for you and any family members/guests and are clear on the risks and benefits of having the test when you sign this consent. You will also be required to sign a document confirming that you are taking the video camera home with you.

What happens if I decide not to have HAEEG?

The decision will be relayed to your referring consultant who may discuss other options or how this can affect your diagnosis.

Is there anything else I should know?

• Please attend with clean, dry hair (no attached weaves or extensions, hairspray, gel, oils, recent perms/dye or other applications)
• It is advisable to have another person with you during set-up in the department and during the recording at home. They can help you with using the equipment, can look after you if you have any typical events/episodes and check that you are visible on the camera
• Please arrive in good time for your appointments (set-up and removal of electrodes). If you think you will be late, please telephone us as soon as possible
• Parking can be difficult- please allow for this and note there is a charge for parking
• There are no facilities for childcare during your appointment. For safety and logistical reasons, children of any age are not allowed in the test rooms
• If you are currently taking any medications you should continue to do so, unless otherwise advised by your doctor/ consultant
• Please bring a list of your medications with you
• You may eat and drink normally before/during your test
• Do not wear tight neck jumpers or tops as you will not be able to remove them once the EEG wires are attached. A shirt or top which has buttons at the front is ideal. If this is not possible, your clothes need to be as loose as possible
• It is advised that you do not leave the house for the duration of the test if possible unless your events occur at night time only
• This test is safe in pregnancy
• If you require an ambulance, you should contact your own GP to make arrangements, and let us know

Privacy

We take issues regarding your privacy extremely seriously and will not show your videos to anyone who is not authorised to look at them. We treat the videos as part of your confidential medical record. We always ask for your permission before showing videos at clinical meetings, for teaching/research purposes as with medical students or for publication in medical journals.

Contact details

For questions or concerns about HAEEG please ring 0161 206 4617
Monday to Friday, 8:30am-4pm

General enquiries/appointments

Please ring 0161 206 2068 Monday to Friday, 8:30am-4pm
Email: reftoneurophys@nca.nhs.uk

Department of Clinical Neurophysiology
Greater Manchester Neurosciences Centre, Salford Royal Hospital, Stott Lane, Salford, M6 8HD.