Scalp video-telemetry - adult inpatient

Your consultant has referred you for a test known as scalp video-telemetry. This leaflet is designed to give you and your family / carers some information about this test and to prepare you for your admission to hospital. To ensure that you are fully prepared for the test and to update us about your present medical condition, we may contact you as part of a pre-admission consultation. PLEASE INFORM US AS SOON AS POSSIBLE IF YOU SUSPECT YOUR PHONE NUMBER IS INCORRECT OR YOU HAVE RECENTLY CHANGED YOUR CONTACT DETAILS.

We hope this information reassures you but if you have further questions or concerns please do not hesitate to contact us using the contact details at the end of this leaflet.

Consent

We must gain your consent for any procedure or treatment beforehand. Staff will explain all the risks and benefits to you before they ask for your consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to ask for more information.

About scalp video-telemetry

What is scalp video-telemetry and why am I having it?

Scalp video-telemetry is a test that allows us to record EEG and video together, usually over a period of a week, while you are in hospital.

EEG, short for 'electroencephalogram', is a test that involves recording your brainwaves with a set of small silver discs, called electrodes, attached to a computer. You may have had one (or more) of these before.

There are many reasons for having scalp video-telemetry. Usually, the referring doctor wants to capture episodes or events that you may be having to help find out more about them (particularly whether they are seizures, and if so, which part of the brain is causing them). Other reasons include capturing night time events, working out if all the events are the same, or checking how many events you are having.

Where is the test performed?

The test is performed on Ward A4 at Addenbrooke’s hospital. Please click here for information on getting to Addenbrooke’s and different modes of transport.

Ward A4 is on level 4 of A block. This is highlighted by a red box in the following map (see map overleaf). You will stay in a single room with en-suite facilities.

Who will be present?

A healthcare scientist will set up and look after all aspects of the EEG and video recording during your admission. Our nurses and doctors specialising in epilepsy and EEG will also visit you to discuss your admission and answer any questions you may have. You will be visited at various points by members of nursing staff working on the ward. A health care assistant will be with you during your admission in order to monitor any events you have and ensure you are safe.

Addenbrooke’s is a teaching hospital and you may be asked if you would consent to trainee staff performing the test under supervision or if you would mind other healthcare professionals / students observing the test. This will be voluntary on your part and it will not affect your treatment if you decline.

What happens during the equipment application?

A healthcare scientist will measure and mark your head using a soft pencil, like a crayon, and a tape measure. They will then clean small areas of the scalp using a cotton bud and gritty paste, like an exfoliator, which is not painful, but does involve some rubbing. Small discs with wires attached will be applied to your scalp using a special sticky paste, a bit like Vaseline®. Everything is held in place with small stickers, netting, bandages and tape. There will also be some electrodes applied to the shoulders and upper parts of both arms to record your heart rate and any movements you make. All the electrodes will be connected to a small box connected to the computer, which you can carry in a backpack or in a bag around the waist.

What happens after the equipment is applied?

You will need to stay in the room and we will continuously monitor your brain activity for the duration of your stay. The video records for the duration of your stay, but we only analyse the video during any events or if there are changes in your brainwaves. We will ask you to press a button or say if you feel an event coming on and check any events you may not be aware of but are reported by staff members.

What about medication?

We may ask you to reduce your medication during your admission as it may help us to record one of your events. This, along with any risks, will be discussed with you before you are admitted. Please do not reduce your medications unless you have been asked to do so, and remember to bring all your regular and ‘as required’ medication with you to hospital when you are admitted.

Are there things to avoid during the recording?

The equipment is sensitive and must stay dry so you cannot wash, brush or apply products to your hair or have a shower (you can wash with a bowl and cloth).

Please avoid chewing gum, as it affects the recording—but continue to eat normal meals.

We advise that you do not leave the room during the recording as far as possible, so that important information is not lost.

How can I prepare for my admission?

Please wash and dry your hair before admission, but do not use any hair-care products.

Unless told otherwise, please continue taking any prescribed medication. It would be helpful if you could bring a list of current medications with you.

It is helpful and more comfortable for you to wear loose fitting clothing, preferably tops with buttons up the front, to avoid anything being pulled over the head whilst changing. To maintain privacy and modesty, we recommend that you wear underwear. We may also ask you to wear special stockings that help to reduce the risk of deep vein thrombosis, which is a potential risk when mobility is limited during your admission.

Although we use infrared to record video overnight, you may still wish to bring an eye-mask as the ward can be quite light.

How long will I be in hospital?

The average stay in hospital is between three and five days, but this depends on how many events you have and what we see on the recording. We will update you each day, but you should plan to be in hospital for five to six days unless you have been informed otherwise.

What are the visiting times?

Please contact ward A4 directly through the main hospital switchboard to check current visiting policies and times.

Can a relative or friend stay with me?

Due to restricted space and limited facilities within the hospital we are unable to provide overnight accommodation. We can provide details of local hotels, bed and breakfast and other types of accommodation available in the area.

Refreshments/ meals

A daily menu sheet will be given to you to choose your meals. Special diets can be requested. You may wish to bring some favourite snacks.

Coping with boredom!

Video telemetry can seem long as you are restricted to one room during admission. We advise you to bring some entertainment such as games, books, arts and crafts etc. Laptops, tablets and mobile phones are also allowed. You may wish to download some movies or TV programmes before your admission as the hospital Wi-Fi is hospital-wide and can be slow. Each bed has a wall-mounted entertainment and telephone system with its own telephone number. You can purchase a reusable card to pay for the TV and telephone; ward staff can give you more information about this on admission.

Can I smoke?

Addenbrooke’s hospital is a no-smoking hospital, meaning smoking is not allowed anywhere and applies to everyone. If you are a smoker and know that not being able to smoke will be difficult during your admission, we recommend that you make an appointment with your GP (several weeks before your admission) to discuss a prescription for nicotine replacement patches or inhalator whilst you are in hospital. We do not recommend nicotine gum as chewing movements interfere with the EEG recording.

Are there any risks?

The recording itself is painless. Occasionally there can be slight redness or skin irritation where the electrodes are on the scalp but the paste itself is water-soluble so can be washed away with shampoo.

The equipment has a long cable to attach the recording box to the computer and you should take care not to trip over this.

There are some risks associated with reducing your medication which we will discuss with you if this is something we recommend for you. Medication will not be reduced without your consent.

When do I get the results?

The results will not be available on the day of the recording. The healthcare scientist and doctor will review the data recorded and prepare a detailed report for the consultant who referred you. The results will be sent to your referring consultant, who will discuss the results with you alongside any other tests that may have been performed.

Contacts / further information

If you need any further information or have any other queries, please call:

Administrator: 01223 216021
Epilepsy nurse specialist: 01223 217992
Clinical physiologist: 01223 217136