Video-EEG monitoring
This is the main tool to localize the “seizures’ focus” (the part of the brain that causes the seizures). The goal is to record seizures (called “ictal”) in order to make sure that all of them come from the same place. As a general rule, the more seizures that are recorded, the more certain we are of where the seizures are starting. In general, we need at least 3-5 seizures. We compare the video (to see what the patient is doing during the seizure) and the EEG (to see where the seizure is coming from) and study both components at the same time. In many occasions we have to provoke the seizures by decreasing the medications for seizures and using special techniques as sleep deprivation, hyperventilation and strobe light stimulation. We also study the brain activity between seizures (called ”interictal”) to see where the epileptiform activity (spikes) is located. At the end of the study, we create a map and correlate the ictal and interictal information.