Neurology and sleep medicine · London
Combined video-EEG polysomnography, simultaneous seizure and sleep monitoring for complex nocturnal events.
Combined video-EEG polysomnography (V-EEG-PSG) records EEG, respiration, oxygen saturation, EMG and video simultaneously overnight. The gold-standard investigation for nocturnal seizures, parasomnias vs epilepsy, REM sleep behaviour disorder and complex nocturnal breathing events.
Why patients choose us
- 01
Two specialists, one night
Your study is jointly interpreted by a consultant neurologist and a sleep physician — because nocturnal events sit between the two.
- 02
Full montage, not a snapshot
Simultaneous EEG, respiration, oxygen saturation, EMG and synchronised video — the gold-standard workup in a single admission.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
The problem
Nocturnal events sit between neurology and sleep medicine.
A plain EEG rarely captures them, a plain sleep study can’t tell you whether they’re epileptic. V-EEG-PSG records both, together, with synchronised video — and is jointly interpreted by the two specialties.
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Unexplained events in sleep?
V-EEG-PSG distinguishes nocturnal seizures from parasomnias in a single admission.
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Dream-enactment behaviour?
Confirms REM sleep behaviour disorder and sets up long-term neurology follow-up.
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Complex nocturnal breathing?
Separates OSA from co-existing movement or seizure disorders, with a joint plan for both.
Preparation and journey
From consultation to joint report — what happens, in order.
One overnight admission, two specialists, one agreed plan.
Phase 1 · Before your study
Consultation and preparation
Phase 2 · On the night
Overnight in the sleep lab
Phase 3 · After
Discharge and joint report
- 01
Before
Neurology and sleep-medicine consultation
A joint pre-study review to confirm V-EEG-PSG is the right investigation and agree the recording protocol.
- 02
Before
Withhold sedatives if requested
Some medications are paused before the study on specialist advice — we brief you on exactly what to hold and when.
- 03
Before
Sleep-lab admission at 8–9 pm
Arrive early evening. A private room with time to settle before setup begins.
- 04
On the night
EEG electrodes plus PSG sensors applied
Full 10–20 EEG montage, respiratory belts, oximetry, EMG and ECG leads — set up by an experienced technologist.
- 05
On the night
Overnight video recording
You sleep as normally as possible while synchronised infrared video, EEG and physiology are recorded throughout the night.
- 06
After
Discharge next morning
Sensors are removed after waking. You go home to shower and resume your normal day.
- 07
After
Report by both specialists
A joint report from the neurologist and sleep physician, with a clear plan for onward care.
Typical end-to-end: 2–3 weeks. Single-night recording, joint report.
What it shows
When V-EEG-PSG is the right investigation.
Combined video-EEG polysomnography answers the questions that a plain EEG or plain sleep study leave open. These are the presentations it clarifies.
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Nocturnal focal or generalised seizures
Distinguishes epileptic seizures arising in sleep from other overnight events.
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Non-epileptic parasomnias (NREM, REM)
Characterises confusional arousals, sleepwalking, night terrors and REM parasomnias.
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REM sleep behaviour disorder
Confirms loss of REM atonia and dream-enactment behaviour — an early alpha-synucleinopathy marker.
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Nocturnal frontal lobe epilepsy
Detects stereotyped brief motor seizures often mistaken for parasomnia.
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Sleep-related hypermotor epilepsy
Captures the hyperkinetic patterns that only manifest during sleep.
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OSA with unusual movements
Separates obstructive sleep apnoea events from a co-existing movement or seizure disorder.
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Nocturnal panic vs seizure
Combined EEG and video clarifies whether waking episodes are epileptic or anxiety-driven.
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Red flag: sustained tonic-clonic seizure — urgent neurology admission
A prolonged convulsion during the study triggers immediate escalation to inpatient neurology care.
Study types
Not all V-EEG-PSG studies are the same.
What each protocol on your referral is actually for.
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Standard V-EEG-PSG
Single-night in-lab study with full EEG, respiration, oximetry, EMG and video — the standard configuration.
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Extended EEG montage
Additional electrode coverage where focal epilepsy is suspected in a specific brain region.
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PSG with limited EEG
Sleep-study focus with a reduced EEG array — used when parasomnia is the leading question.
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Repeat V-EEG-PSG
Second-night recording when the first study was uninformative or events were not captured.
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Post-treatment V-EEG-PSG
Confirms response to anti-seizure medication, CPAP or REM-behaviour-disorder therapy.
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V-EEG-PSG for surgical workup
Feeds into a structured epilepsy MDT review when surgical treatment is being considered.
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Paediatric V-EEG-PSG
Age-appropriate protocol for children with suspected nocturnal seizures or complex parasomnias.
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Ambulatory follow-on EEG
Home-based EEG after the in-lab study when longer sampling is needed.
Our vetted London network
A small panel of sleep labs, we picked them.
Sleep-lab partners across central and greater London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every sleep lab in our network.
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Consultant neurologists with epilepsy sub-specialty interest
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Consultant sleep physicians accredited by the British Sleep Society
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AASM-standard polysomnography with synchronised video and EEG
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Structured onward pathway to epilepsy MDT, sleep clinic or surgical review
Safety and red flags
A safe overnight study — with clear escalation for the serious findings.
V-EEG-PSG is a low-risk investigation, but the conditions it uncovers can be serious. We flag SUDEP risk, refractory epilepsy and REM behaviour disorder with alpha-synucleinopathy explicitly.
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A single overnight admission
One night in a private sleep-lab room — no anaesthetic, no radiation, no injections.
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Setup takes about an hour
The technologist applies the electrodes, belts and sensors before lights-out — none of it is painful.
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You can move and turn as usual
The cabling is designed to let you sleep in your normal position; the video is infrared and non-intrusive.
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Medication changes only on advice
Never stop anti-seizure or sedative medication yourself — the specialist team tells you exactly what to hold.
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A sustained convulsion is an emergency
If a prolonged tonic-clonic seizure occurs during the study, the team escalates to inpatient neurology admission.
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REM behaviour disorder needs follow-up
A positive study is only the start — long-term neurology follow-up matters because of the alpha-synucleinopathy link.
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A negative single night isn’t a full clear
Some events are infrequent — if nothing is captured, a repeat or ambulatory study may still be needed.
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Pregnancy and epilepsy
Pregnant patients with epilepsy need a joint obstetric-neurology plan alongside the study.
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Bring prior EEGs and sleep studies
Comparison against previous recordings materially sharpens interpretation.
Red flags flagged in the report
- Sudden unexpected death in epilepsy (SUDEP) risk
- New-onset nocturnal seizures
- REM behaviour disorder with alpha-synucleinopathy
- OSA plus refractory hypertension
- Severe fatigue and cognitive decline
- Pregnancy with epilepsy
- Post-traumatic epilepsy
- Refractory epilepsy for surgical workup
- Frontal-lobe epilepsy masquerading as parasomnia
Reading your report and next steps
A V-EEG-PSG report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts — and comes with a clear plan for what happens next.
Treatment and next steps
- · Reassurance if benign parasomnia
- · Anti-seizure medication
- · CPAP for OSA
- · REM-behaviour-disorder therapy (melatonin, clonazepam)
- · Neurology follow-up
- · Sleep-medicine follow-up
- · Structured epilepsy MDT review
- · Family-support pathway
- 01 Header
Indication and background
Your details, the clinical question, medications and prior EEG or sleep-study results.
- 02 Technique
Montage, sensors and recording quality
The EEG montage used, the PSG channels recorded and any technical caveats about the night’s data.
- 03 Findings
Sleep architecture, EEG and captured events
Sleep-stage summary, respiratory indices, EEG background, and a description of every event captured on video and EEG.
- 04 Impression
The joint conclusion: read this first
A single agreed answer from neurology and sleep medicine, with the concrete next step — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about combined video-EEG polysomnography.
Quick answers on what the study involves, medication, single-night limits, and how a joint neurology and sleep-medicine report is written.
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What is combined video-EEG polysomnography?
V-EEG-PSG records EEG, respiration, oxygen saturation, EMG and synchronised video simultaneously overnight in a sleep lab. It is the gold-standard investigation for nocturnal seizures, parasomnias vs epilepsy, REM sleep behaviour disorder and complex nocturnal breathing events.
-
Why is V-EEG-PSG better than a plain EEG or plain sleep study?
A plain EEG rarely captures nocturnal events, and a plain sleep study cannot tell you whether an event is epileptic. Recording both together, with synchronised video, is the only way to answer both questions in a single night.
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How long is the study?
A single-night in-lab study. You are admitted at 8–9 pm, the setup takes about an hour, you sleep overnight while everything is recorded, and you are discharged the following morning.
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Do I need to stop my medication?
Only on specialist advice. Some sedatives are withheld before the study, but never stop anti-seizure medication on your own — the neurology and sleep-medicine team will tell you exactly what to hold and when.
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What if nothing happens on the night?
A single negative night doesn’t exclude the diagnosis — some events are infrequent. Options include a repeat V-EEG-PSG, a longer ambulatory EEG at home, or a targeted approach based on the events you describe.
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Who reports the study?
The recording is jointly interpreted by a consultant neurologist and a consultant sleep physician. You receive a single agreed report with a clear onward plan — anti-seizure medication, CPAP, REM-behaviour-disorder therapy, or a structured epilepsy MDT review.
Sources
Guidelines behind this guide.
Reviewed by Pulse Atlas Editorial Board () · Published 2026-07-30 · Next review 2027-07-30 · 7-minute read.
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In practice, in London
The London pathway for combined video EEG polysomnography
With combined video EEG polysomnography, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for combined video EEG polysomnography vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A typical private booking for combined video EEG polysomnography in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For combined video EEG polysomnography specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see combined video EEG polysomnography — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.