EEG and SEEG

Video‑EEG

What is a video‑EEG?

A video‑EEG, or video electroencephalogram, is an examination in which we record your child’s brain activity and video images at the same time.
This allows us to see exactly what a seizure looks like and what happens in the brain during that moment.
This information helps us better understand where the seizures originate and how to further refine the treatment plan.

How does a video‑EEG work?

Applying the electrodes

Nurses place electrodes (small sensors) on your child’s head using a special gel or paste.

• This does not hurt.
• The cables are bundled into a small backpack so your child can still move around freely in the room.

The monitoring environment

The examination takes place in a specially equipped room containing:

• EEG equipment
• video cameras
• appropriate lighting

The video images help the team interpret what happened during moments of abnormal brain activity.

24 hours

We often monitor your child’s brain activity for 24 hours. A longer recording helps us get the clearest possible picture of what’s going on. It allows us to:

• Increase the chance of detecting any abnormalities
• See how the brain functions during different activities throughout the day
• Observe brain activity while your child is asleep

Throughout the entire monitoring period, you stay together with your child in the room and sleep there as well.
To keep the recording accurate and secure, your child will need to remain in the room until the test is finished.

Why is this examination done?

The goal of a video‑EEG is to:

• record spontaneous seizures in a safe and controlled environment,
• determine where in the brain the seizure starts,
• create an electro‑clinical correlation: linking what we see on video with what we see on the EEG.

Because it is important that seizures occur during the admission, it may sometimes be necessary, depending on the treatment plan, to temporarily reduce medication.
This is always done carefully and under continuous supervision.

Continuous observation and interpretation

During monitoring, your child is observed 24/7:

• During the day, the EEG laboratory staff review the incoming data.
• At night, the ward nurses monitor the EEG closely; the interpretation takes place the next day.

Every visible change in behaviour or movement on video is matched with the EEG activity.
This provides highly valuable information for the epilepsy team.

After the examination

Once enough information has been collected, the electrodes are removed and your child may go home.
The results are discussed thoroughly later within the multidisciplinary epilepsy team.

More information on uzleuven.be

Stereo‑EEG

What is an SEEG examination?

SEEG (stereo‑EEG) is an invasive epilepsy investigation in which thin intracerebral electrodes are placed inside the brain.
This is only done when earlier, non‑invasive tests (such as MRI, PET, SPECT/SISCOM, or video‑EEG) do not yet provide sufficient clarity about where the epilepsy originates.

The purpose of SEEG is to identify the epileptogenic zone with great precision, so the team can determine whether epilepsy surgery is possible and meaningful.

Careful preparation

Several specialists are involved in planning a SEEG procedure, including neurosurgeons, epileptologists and neuroradiologists.

• The electrode trajectories are carefully planned using advanced neuroimaging and computer‑based navigation.
• The plan is fully tailored to your child’s brain, ensuring that electrodes are placed safely and accurately.

The operation

• The procedure is performed under general anaesthesia. Your child sleeps deeply and feels nothing.
• The neurosurgeon places the thin electrodes through small openings in the skull, positioning them precisely in the brain.
• Afterwards, your child is admitted to a monitoring unit for observation and further recording.

Hospitalisation typically lasts 1 to 2 weeks, depending on how much information is needed.

The registration phase: what happens next?

Once the electrodes are in place, a period of continuous EEG recording begins.

During this phase:

• spontaneous seizures are recorded, and sometimes
• seizures are safely and carefully induced (for example, by temporarily reducing medication, only if medically justified).

Because the electrodes measure directly inside the brain, the doctors can see with great precision:

• where seizures begin,
• how they spread,
• and which brain regions are involved.

Your child is monitored 24/7, both clinically and via video and EEG.
Parents may remain with their child, except in specific medical situations where this is not possible. The team will always inform you clearly.

Why SEEG can be important

Information from SEEG is essential to determine:

• whether epilepsy surgery is an option,
• which part of the brain could be safely treated,
• and which surgical strategy would offer the best and safest outcome.

SEEG is only used when truly necessary, but it can provide crucial insights into the epilepsy and possible treatment options.

After the examination

When enough information has been collected:

• the electrodes are removed during a short procedure,
• your child gradually recovers,
• and all collected data are discussed within the multidisciplinary epilepsy team.

You will then receive extensive feedback about the findings and the possible next steps in treatment.