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Referral Form for my Doctor

Routine and Ambulatory EEG with Video Monitoring

What can cause
a Seizure ? 

Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure.


What are Seizures? 

Cognitive or emotional symptoms, loss of consciousness or awareness, temporary confusion, uncontrollable jerking movements of the arms and legs.

Common Neurological Disorders

What is an 
electroencephalogram (EEG) study ?

It records electrical activity in your brain using electrodes attached to your scalp.

Routine (REEG)

30 - 40 minutes of monitoring.

Ambulatory (AEEG)

24 - 72 hours of monitoring. Video

recording may also be requested.


What equipment is used ? 

  • Data Recorder

Usually battery powered and mobile, records all brain activity

  • Video Recorder (if ordered)

Will record all movements while you are awake or asleep

  • Echocardiogram (ECG) patches

Added to your upper chest area for heart monitoring.

a woman lays with EEG hooked up - BioSerenity, Sleep Research and Solutions
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