For electrode application, the decision to use collodion versus paste and tape must consider possible aerosolization risk with collodion application against the need to reapply paste and tape electrodes due to poor adherence.
The test’s length should be sufficient to address patient management while maintaining minimal standards.
Hyperventilation should not be routinely performed. If justified for high diagnostic yield (e.g., pediatric absence epilepsy), patients must wear surgical masks.
In the inpatient setting, equipment should be outside the patient’s room using a long cable if possible. Stimulation for reactivity assessment can still be performed.
Nasal/oropharyngeal swab test for rapid COVID-19 detection could be considered at admission to EMU with the aim to mitigate contagious risks.
EMU admissions should consider whether a single companion is allowed in the EMU when needed for safety and/or diagnostic accuracy.
Priority indications may include but are not limited to: potential for management changes based on monitoring, pre-surgical workup (phase I, II, and ictal SPECT), high seizure burden, SUDEP risk, threat of disease worsening, and frequent emergency department visits.
If ambulatory EEG is used as an EMU alternative it should include video, ideally with outpatient dis/connection.
VNS/DBS insertion for epilepsy, setting revisions, or battery exchange should be considered only if seizure frequency and severity outweighs COVID-19 risk.
Cleaning of EP equipment must use disinfectants that are compatible, and if using earbuds or inner ear electrodes for BAEP, they must be discarded after each use.
