FAQ's on Vertigo

Q- What are the preventions for Vertigo?
Ans- People whose balance is affected by vertigo should take precautions to prevent injuries from falls.
Those with risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking.
Someone with Meniere disease should limit added salt to their diet.

Q- What are the prognosis for Vertigo?
Ans- The prognosis depends on the source of the vertigo.
Vertigo caused by problems in the inner ear, while usually self-limited, in some cases can become completely incapacitating. The use of drugs and rehabilitation exercises are the mainstay of treatment. Most commonly this will make the symptoms completely go away or make the condition tolerable.
The prognosis of vertigo from a brain lesion depends on the amount of damage done to the central nervous system. All vertigo caused by a brain lesion needs emergency evaluation by a neurologist and Video electroencephalogram.

Q- What is Video EEG Monitoring?
Ans- It is a procedure when the EEG is recorded for a prolonged period after an advice from the physician and is accompanied by continuous closed-circuit video observation. The digitized EEG and recorded behaviour are displayed simultaneously, allowing point-to-point correlations of recorded events and any accompanying electrographic changes. This allows localisation of seizure origin.

Q- Why do I need Video EEG Monitoring?
Ans- Epilepsy is a disease of the brain caused by abnormal electrical activity. Video EEG monitoring enables your doctor to observe your seizures and the EEG at the same time. Video monitoring can help diagnose your seizure type and provides important information regarding the best treatment for your seizures. Video monitoring is also used in the evaluation for epilepsy surgery. In some patients, epilepsy can be helped or even cured by surgery. Video EEG monitoring is considered medically necessary when specific patient selection criteria are met, as outlined below may be considered for other situations. Video EEG monitoring is considered appropriate for patients who meet any of the following criteria:
Diagnosis could not be made on the basis of a neurological examination and /or standard EEG studies.
Presence of intractable / uncontrolled seizure activity despite conventional treatment, including anti-epileptic medication(s) and adequate dosage of medication(s) and patient compliance has been assured.
Non epileptic seizures secondary to other diagnoses have been ruled out (e.g. syncope, transient ischemic attacks, etc.).
To differentiate between true seizures and pseudo seizures.

Q- Why is the Process of Monitoring?
Ans- It shall be performed on an inpatient basis, depending on the frequency and duration of seizure activity and length of time necessary to collect data. EEG monitoring would be required for patients such as those having infrequent clinical seizures, with seizures that are clinically severe (such as prolonged complex partial seizures), or are provoked by drug withdrawal.
A video recording is done by 21 to 44 channel EEG monitoring in order to capture the patient's behaviour and the corresponding EEG pattern.
The video EEG allows clinicians to examine changes in the EEG along with the clinical manifestations of seizures as they occur.
Patient preparation:
Patient is asked to bring all previous medical records and OPD prescriptions.
They must tell the physician about history of medication intake
Instructions given to the patient the night before to:
Avoid caffeine for 24 hours before the EEG.
Eat normally
Limit or avoid smoking for 24 hours before the test
Shampoo the hair before the EEG.
Do not apply hair spray or gel before the EEG
Stoppage of antiepileptic drugs before 24 hours or as instructed by the consultant

Q- Why is the procedure of performing the test?
Ans- The staff receives the request for EEG duly signed by a Senior Consultant/ designee.
He /she ensures that patients get registered on the counter and checks the bill. The technician introduces himself and explains the EEG procedure to the patient under supervision of consultant.
Technician obtains all patient data needed for the EEG report and billing i.e. patient's name, medical record number, date of birth, referring physician, patient location, and procedure number.
Clinical information including type of procedure requested, reason for EEG, relevant symptoms, and description of seizure and current medications shall be checked by the doctor.
The physician ensures medications are listed and spelled correctly.
Thereafter the patient data is logged in correctly.
The technician verifies physician signature on request form and thereafter adjusts the machine settings to obtain optimum accurate recording.
Electrodes are applied correctly within 30 minutes, their functioning verified and the patient instructed to open and close eyes, hyperventilation and photic stimulation.
Significant EEG patterns include normal variants, artefact patterns and abnormal EEG patterns are identified, electrodes removed correctly and the patient’s scalp cleaned.
All the EEG data for interpretation by the consultant is edited / archived by the technician
 During the procedure The patient's state of alertness is measured periodically. Patients with coma or altered mental state may be tested with auditory or tactile stimulation. Patients with seizures or pseudo seizures are tested for responsiveness.
Photic stimulation and hyperventilation: The patient is asked to perform 3 minutes of hyperventilation when there are none of the contraindications of cardiac / respiratory disease / sickle cell disease / severe hypertension /acute stroke.

Q- Why are the risks of monitoring?
Ans- All medical procedures carry a certain amount of risk. Although video monitoring is relatively safe, one could have an uncontrollable seizure, or may experience unusually severe seizures or could confront with emotionally upsetting information when the doctor should be consulted.