What to expect during the Epilepsy Monitoring Unit stay

EMU

The EMU is a specialized unit at the epilepsy centers designated to observe, evaluate and diagnose your seizures.

The multidisciplinary team of health care professionals will be involved in the evaluation of your seizures when hospitalized in the Epilepsy Monitoring Unit (EMU). The multidisciplinary team of professionals includes epileptologists, general brain doctors or neurologists, brain surgeons or neurosurgeons, psychologists, radiologists, nurses, technicians, social workers and other personnel with experience in epilepsy.

All the information put together during this monitoring phase will help not only to identify the type of seizures but all other characteristics related to them that are necessary to plan your treatment.

Your epileptologist or the institution will provide you and your family with a list of recommendations and instructions to follow before and during your stay in the EMU. Make sure you read and follow them.

Before admission

Make sure you read and follow any recommendations provided to you and your family.

  • Wash your hair with shampoo and do not use conditioner, sprays, gels or any other products. Dry and leave long hair down the day of admission.
  • Pack comfortable clothes including button down shirts and sweatpants.
  • Bring favorite devices with chargers, books or board games to keep you entertained.
  • Do not make changes to your medications before admission unless your doctor tells you to do so. Bring all the medications you are currently taking.

During admission

A family member, partner, close friend or a nurse might be allowed to stay with you during the monitoring evaluation. Relatives or your friend can help with the description of the seizures and let the clinicians know if the events that happen at home or out of the hospital are similar to the ones experienced in the EMU. They can also help you if seizures occur or if you need to move out of bed, to avoid injuries.

  • Once you are admitted to the EMU, you may be assigned to a private room. The electrode cables placed on your head will be connected to the devices in the room to have continuous recordings of your brain activity. These cables will be long enough for you to move around the room and to go to the bathroom. The electrodes will be re-assessed on a daily basis to make sure they are in the right position until you are discharged.
  • An intravenous (IV) line will be placed on one of your veins to administer medications and for emergency purposes. Seizures may be induced by changing the dose or stopping the anti-seizure medications you are regularly taking. For safety reasons the clinicians will be able to give you medications to control those seizures using the IV line.
  • The room will be equipped with a video camera and microphones tracking your brain activity. You won’t be recorded in the bathroom. The video-EEG will be monitored 24/7 by trained staff and they will take care of you when seizures occur.
  • Besides making changes to your anti-epileptic medications, you may be asked to stay awake, breathe deeply, do some exercises or be exposed to flashing lights to induce seizures. All these activities will be carefully recorded with the video-EEG and imaging to evaluate the events you are having.
  • Aside from the video recordings, your vital signs will be checked periodically and if required, other tests may be performed. The specialists will provide you with daily updates on the progress and what they have found.
  • You may be monitored from a few to several days. The length of stay in the EMU varies depending on the type and frequency of your seizures. The specialists may order additional tests or ask you to see other doctors if it becomes difficult to capture typical seizures or to get conclusive information.
  • In some centers, you may be approached to participate in research. We do not understand enough about how the brain works, or about epilepsy, so this is an opportunity to help move brain science and our understanding of epilepsy forward. Participation in research is always voluntary and, if you do not participate, this does not affect your clinical care.

After admission

  • The multidisciplinary team members will meet to review and discuss the results from the tests. This may happen towards the end of your stay, or shortly after your hospitalization.
  • Because every person with drug-resistant epilepsy is different, the process to make a decision about the appropriate therapy will depend on individual situations and the results from the tests.
  • Once the team has a final decision about the treatment that is more appropriate, they will share with you and your family the care plan. This is the right time to ask as many questions as possible and will give you the opportunity to understand the next steps.
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