An ambulatory electroencephalogram (EEG) is a test that records the brain’s electrical activity over about 24 to 72 hours, during which your child goes about their normal daily life. Unlike a standard EEG, which is done in the clinic in 20 to 40 minutes, an ambulatory EEG captures brain activity across a much longer window, including during sleep, meals, school, and play.
A short in-clinic EEG can sometimes return normal results, even in a child with regular episodes, because nothing occurred during that brief recording window. An ambulatory EEG, on the other hand, is a far more informative test for children whose symptoms are intermittent or haven’t been explained by previous testing.
What symptoms are we discussing? Your child might need an ambulatory EEG if they’ve been having episodes that could be seizures, if a previous EEG was inconclusive, if a known seizure disorder needs closer monitoring, or if there are behavioral or cognitive changes that we want to investigate further.
Once the results come back, Dr. Henry Hasson, a pediatric neurologist in Brooklyn, New York, will explain what they mean and map out what to do next based on the recording. Here, he covers what EEG results can show, how they’re interpreted, and, depending on what he’s found, what the next steps typically look like.
An ambulatory EEG records continuous brainwave activity and looks for patterns that fall outside the normal range. Normal results mean that no abnormal electrical activity was detected during the monitoring period. This doesn’t necessarily mean nothing is wrong; it means nothing abnormal occurred while the recording was running.
If your child’s symptoms are infrequent, they may not have had an episode during the monitoring window, and a normal result in that context doesn’t rule out a seizure disorder. Dr. Hasson will consider the full clinical picture alongside the EEG findings rather than making decisions based on the recording alone.
Abnormal results can take a number of forms. The recording might capture a seizure, which allows Dr. Hasson to classify the seizure type based on how the activity looks and where in the brain it originates. It might show brief abnormal electrical patterns that occur between seizures. It might also show patterns associated with specific epilepsy syndromes.
If your child’s episodes are continuing and the EEG didn’t capture one, Dr. Hasson may recommend repeating the test, extending the monitoring period, or exploring other possible explanations for the symptoms. In some cases, a normal EEG combined with the clinical history is enough to confidently rule out certain conditions.
When the EEG captures abnormal activity, the type of abnormality found guides what comes next. If it’s a specific seizure type, Dr. Hasson will prescribe medication based on what works best for that seizure type in children your child’s age. If the pattern is consistent with a recognized epilepsy syndrome, he’ll create a longer-term management strategy and monitoring schedule and gently explain what to expect going forward.
Not all abnormal findings require immediate treatment. Some patterns indicate an elevated risk of seizures without confirming that seizures are happening, and in those cases, Dr. Hasson may recommend monitoring rather than starting medication straight away.
When treatment is needed, anti-seizure medication is the most common starting point. Finding the right medication and dose for your child takes time and requires close follow-up. Dr. Hasson will monitor their response carefully, adjusting the plan as needed based on how well the seizures are controlled and how your child tolerates the medication.
Alongside medication, he typically provides families with guidance on seizure safety. These are practical steps to keep your child safe at home and at school and during everyday activities. Follow-up EEGs are scheduled periodically to track how your child’s brain activity changes over time in response to treatment.
An ambulatory EEG gives Dr. Hasson a level of insight into your child’s brain activity that a standard EEG often can’t. What comes after the results depends on what the recording shows. If your child has had or needs an ambulatory EEG, book a consultation online with Dr. Hasson today or call 718-785-9828.
