Inpatient Epilepsy and Seizure Monitoring

The Northwestern Medicine Epilepsy Monitoring Unit (EMU) at Northwestern Memorial Hospital allows for patients with epilepsy and seizure disorders to be monitored in the hospital for several days. Video EEG monitoring is often performed to identify seizure activity or any unusual electrical activity in the brain to help provide an accurate diagnosis.

Specially trained EEG technologists will explain the monitoring equipment after they have placed the electrodes. They will discuss:

  • Use of an event button
  • Normal sounds the machine makes

A technologist will monitor you 24 hours a day for any seizure activity. With each seizure, you will be contacted by EMU medical staff, including: physicians, EEG technologists, and nurses, who will ask questions and may have you perform motor tasks.

Diagnostic Video

Diagnostic Video EEG monitoring is used to diagnose patients who do not respond to epilepsy medications. Video EEG monitoring is continuous EEG monitoring and continuous videotaping of the patient. This monitoring is usually performed in the hospital over several days.

This allows the physician to observe the behavior that occurs during the seizure and how it is related to the electrical activity in the brain. Often the patient's anti-epileptic medication is reduced to allow seizures to occur so they can be recorded. Video EEG monitoring can help to:

  • Confirm the diagnosis of epilepsy
  • Determine the type of epilepsy and the best medication for it
  • Allow medication change under supervision
  • Pinpoint the region of the brain where the seizures begin, which is essential if epilepsy surgery is being considered
  • Learn what to expect during Video EEG Monitoring

Presurgical Evaluation

Some patients who do not respond to anti-epileptic medications may benefit from epilepsy surgery-50 to 80 percent of patient who are suitable candidates for surgery are seizure-free after surgery. Proper patient selection and a thorough presurgical evaluation are the cornerstones of surgical success. The presurgical evaluation is a relatively lengthy process which may take several months.

Invasive (Stereo EEG and subdural grids)

Sometimes, routine EEG may not be sufficient to get as precise a brain wave reading as possible for patients with epilepsy and other seizure disorders. In these cases, it may be necessary to use intracranial monitoring to get the proper mapping of the focus of epilepsy.

For deep-brain seizure focus, depth electrodes may be used. In the case of seizure focus on the surface of the brain, subdural electrodes may be used.

Stereo EEG has been shown to be successful in localizing epilepsy focus, with a low rate of complications, with less post-operative pain than the use of subdural electrode grids.