Patient guide · Clinical neurophysiology
Home video telemetry, continuous multi-day EEG + video recording in your own home for epilepsy characterisation.
Continuous EEG plus time-linked video, recorded in your own home over 3 to 7 days. It picks up more than a standard ambulatory EEG. It helps characterise seizures, tells epileptic from non-epileptic events apart, and supports pre-surgical planning.
Key facts
- 01
What it is
Multi-day EEG paired with time-linked video, recorded in your own home.
- 02
3–7 day recording
Extended recording captures events that a short ambulatory EEG will typically miss.
- 03
Time-synced video
Each event is linked frame-by-frame to the EEG trace, allowing precise semiology classification.
- 04
Higher diagnostic yield
Materially greater yield than a standard ambulatory EEG for characterising seizures.
- 05
Avoids in-patient admission
Reduces the need for hospital telemetry admission in appropriately selected patients.
- 06
Consultant-reported
Interpreted by a consultant clinical neurophysiologist with epilepsy expertise.
How it works
From consultation to report — what happens, in order.
A clear seven-step pathway, from your first neurology consultation to a written neurophysiology report.
Phase 1 · Before the recording
Consultation and set-up
Phase 2 · During recording
3–7 days at home
Phase 3 · After
Reporting and follow-up
- 01
Before
Neurology consultation
A consultant neurologist confirms the indication, discusses expected events and sets the recording plan.
- 02
Before
EEG electrodes applied at home
A neurophysiology technologist attends your home to place scalp electrodes and secure the head-box.
- 03
Before
Video camera installed
A time-synchronised camera is positioned to capture the areas where events typically occur.
- 04
During
Wear the equipment for 3–7 days
You go about your normal routine at home. Battery packs and storage are swapped as needed.
- 05
During
Diary of events and medications
Log any events, sleep, medication timings and possible triggers to correlate with the trace.
- 06
After
Return the equipment
The technologist retrieves the kit and uploads the full recording for review.
- 07
After
Written neurophysiology report
A consultant clinical neurophysiologist reports the study, with onward referral where indicated.
Typical recording period: 3–7 days, at home.
What it shows
When home video telemetry is the right test.
Home video telemetry answers a specific question — what type of events are these, and are they epileptic. These are the presentations it helps most.
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Focal seizures
Localises focal-onset seizures and helps identify a candidate epileptogenic zone.
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Generalised seizures
Characterises generalised epilepsies and captures ictal EEG patterns.
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Non-epileptic attack disorder (NEAD)
Distinguishes dissociative non-epileptic events from true epileptic seizures.
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Nocturnal frontal-lobe epilepsy
Captures stereotyped nocturnal motor events that a short EEG will typically miss.
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Sleep-related events
Clarifies parasomnias and sleep-related motor events against the EEG background.
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Cardiac cause differential
Helps flag when a cardiogenic cause of collapse should be considered.
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Autonomic seizures
Captures autonomic phenomena such as pallor, flushing or vomiting with EEG correlate.
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Red flag: status epilepticus captured — emergency admission
If prolonged or recurrent seizure activity is seen, arrange immediate emergency admission.
Next steps
What follows the report.
The pathway after the report depends on what the recording shows — from medication changes to pre-surgical workup.
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Anti-seizure medication optimisation
Rationalise or introduce anti-seizure medication based on the characterised event type.
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Pre-surgical epilepsy workup
Feeds into a formal pre-surgical evaluation where drug-resistant focal epilepsy is confirmed.
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Referral to epilepsy MDT
Discussion at a specialist epilepsy multidisciplinary team meeting for complex cases.
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Psychological therapy for NEAD
Structured psychological therapy where non-epileptic attack disorder is diagnosed.
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Cardiology assessment
Onward cardiology review if a cardiac cause of collapse is suspected.
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Sleep medicine review
Sleep medicine input for parasomnias or sleep-related motor events.
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Driving-restrictions advice
Clear guidance on DVLA obligations and driving restrictions after the diagnosis.
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Structured neurology follow-up
Planned neurology follow-up to review response and adjust the plan.
Red flags
When something needs urgent attention.
These features change the plan — some warrant same-day medical assessment, others require immediate emergency admission.
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Status epilepticus
Prolonged or repeated seizures without recovery — a medical emergency requiring immediate admission.
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SUDEP risk factors
Nocturnal seizures, poor control and generalised tonic-clonic seizures raise sudden-death risk.
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New-onset focal seizures
First-onset focal seizures in an adult warrant urgent imaging and neurology review.
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Post-injury seizures
New seizures after head injury require urgent imaging and neurology assessment.
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Refractory epilepsy
Failure of two appropriately chosen anti-seizure medications defines drug-resistant epilepsy.
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Autoimmune encephalitis
Rapid cognitive change, psychiatric features and seizures require urgent specialist work-up.
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Pregnancy with epilepsy
Pregnancy raises specific medication, folate and monitoring considerations.
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Cardiac cause of collapse
Sudden collapse without warning, palpitations or exertional syncope warrant cardiology input.
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Central sleep disorder
Suspected central sleep-related disorder needs sleep medicine assessment alongside neurology.
Sources and guidelines
Written against the current guidance.
Reviewed on 2026-07-30. Next scheduled review 2027-07-30. Estimated reading time 6 minutes.
A quiet reminder
This is a patient guide, not a substitute for personal medical advice.
Discuss your own history and options with your consultant neurologist.
- 01 Source
NICE. Epilepsies in children, young people and adults (NG217).
NICE. Epilepsies in children, young people and adults (NG217).
- 02 Source
International League Against Epilepsy (ILAE). Clinical practice guidelines and classification.
International League Against Epilepsy (ILAE). Clinical practice guidelines and classification.
- 03 Source
British Society for Clinical Neurophysiology. Guidelines for long-term monitoring.
British Society for Clinical Neurophysiology. Guidelines for long-term monitoring.
- 04 Source
Epilepsy Society UK. Patient information on video telemetry.
Epilepsy Society UK. Patient information on video telemetry.
Frequently asked
Everything patients ask about home video telemetry.
Quick answers on how the test differs from a standard EEG, how long it runs, and who reports it.
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What is home video telemetry?
Home video telemetry is a continuous multi-day EEG recording combined with time-synchronised video, carried out in your own home over 3–7 days. It captures both the electrical activity of the brain and the clinical appearance of any events, allowing them to be classified precisely.
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How is it different from a standard ambulatory EEG?
A standard ambulatory EEG records brain activity alone, usually over 24–48 hours. Home video telemetry adds time-synced video and typically runs for 3–7 days, giving a materially higher diagnostic yield for characterising seizures and distinguishing them from non-epileptic events.
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How long does the recording last?
Recordings usually run for 3–7 days, depending on how often events occur and what the neurologist needs to capture. Longer recordings are used where events are infrequent.
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Can it diagnose non-epileptic attack disorder (NEAD)?
Yes. One of the key strengths of video telemetry is the ability to distinguish epileptic seizures from dissociative non-epileptic attack disorder by capturing events on both EEG and video simultaneously.
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Do I have to stay in hospital?
No. Home video telemetry is designed to keep you in your normal environment, which often triggers events that a hospital admission would miss. It reduces the need for in-patient telemetry in appropriately selected patients.
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Who reports the study?
The recording is reviewed and reported by a consultant clinical neurophysiologist with epilepsy expertise, with onward neurology or epilepsy MDT referral where indicated.
Related tests
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In practice, in London
The London pathway for home video telemetry
With home video telemetry, 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 home video telemetry 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.
In practice, a private home video telemetry appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For home video telemetry specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for home video telemetry isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.