"It's the coolest little thing," says Dr. Karen Keough. "It's not quite as small as a laptop, but it's not much bigger than that, and it's really, really portable."
Keough is talking about the portable electroencephalogram — EEG — machine that her patients at Child Neurology Consultants of Austin have been able to use in their homes instead of spending a night or two in the hospital.
In her patients' cases, the EEG machine is looking for seizures almost exclusively for kids who have epilepsy.
It's not for every one of her patients, though. Usually Keough recommends it when she's trying to evaluate if a medication is working or determine what kind of seizure kids are having.
She can't use it for patients whom she's trying to evaluate for a future surgery. That testing is still done in a hospital setting where there is more minute-by-minute testing. It also can't be done on kids who behaviorally will try to pull all the electrodes out.
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She also can't use the at-home EEG in a study when she is taking away medication to see if seizures are still happening. That testing also gets done in the hospital.
With the portable EEG, a technician comes to the patient's home and attaches electrodes to her head with surgical glue. She first measures the patient's head to see how many electrodes to use and where to place them and then begins gluing them on. She then wraps the head to keep the electrodes in place and attaches all the wires to a pack inside a small backpack that the patient can carry with them. Through an internet connection, the electrodes send data to the portable EEG.
The technician also hooks up two cameras, usually one in the bedroom where the child sleeps and one in the main living area. Those video cameras also send images to the portable EEG machine monitor.
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It takes about 30 to 40 minutes to attach everything. Then the technician leaves and remotely monitors the patient throughout the study, which can be for one to three days at a time. Occasionally one of the electrodes comes loose and the technician might have to return to reattach it, or she might talk the parents through reattaching them using the supplies she leaves for them.
Child Neurology Consultants of Austin EEG technician Kimberly Dodson says they now have three machines and they are testing three to six patients a week. Usually it goes pretty smoothly, though with younger kids, they can sometimes pull the leads out, especially the ones that go on the body to pick up the movement of the seizures. The head ones tend to stay glued in, she says, because she wraps the head with gauze pretty tightly to keep everything in place.
The advantage of the portable EEG is that it is less disruptive on family life because no one has to spend the night in the hospital. Patients do need to stick close to home so that their seizure activity can be recorded on video.
It's also less expensive because it doesn't require a hospital stay. Often, Keough says, this EEG is easier for insurance to authorize because of the cost savings.
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James and Angie Balentine have had the at-home EEG done on their daughter Araceli twice. Araceli, 4, has KCNQ2, a genetic disease that includes seizures. They first noticed something was wrong when she was 5 weeks old.
Before the portable EEG, they would have to spend days in the hospital, which meant that one parent would have to spend the night there while the other parent would be at home with the other two children.
"For her, this is much better," James Balentine says. "She already has a lot of sleep issues, and at the hospital she has way more."
Keough says her patients "appreciate how much less disruptive it is on the day-to-day," she says.
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