Inpatient Seizure Monitoring and Epilepsy Monitoring Unit (EMU)

Your physician may order an inpatient evaluation in the Epilepsy Monitoring Unit (EMU) to monitor for seizures or other brain events. Inpatient seizure monitoring may be suggested if you have persistent seizures; it can help pinpoint the cause of the seizures and/or help determine if you are a potential surgical candidate. Your physician will use the information gathered in the EMU to help diagnose your events and find the best treatment options for you.

During routine inpatient seizure monitoring, you will be connected to continuous video EEG and closely monitored by the EMU staff. In this setting, your physician may decide to alter your medication dosage or use different strategies to trigger an event to capture it. Staff will monitor you around the clock.

For surgical candidates

If you are a surgical candidate, we may offer invasive EEG monitoring to pinpoint the area where seizures arise. This is done by surgically implanting depth electrodes into the brain, or implanting a grid of electrodes on the surface of the brain.

On the day of admission, you will go to the operating room, and the electrodes will be placed by a neurosurgeon who specializes in epilepsy surgery. After the surgery, you will spend one night in the neurological intensive care unit. The following morning, you will transfer to the EMU, and your anti-seizure medications will be stopped or weaned. The implanted electrodes are used to monitor for seizures.

Before you are discharged from the EMU, you will return to the operating room to have the electrodes removed. All medications will be restarted for 24 hours before discharge.

What to expect during an EMU visit

You will be greeted by a patient liaison who will ask for any additional information needed to complete your records. Then you will be escorted to your room, where an EEG technologist will place the EEG electrodes on your head. A resident physician will ask you questions about your symptoms and examine you.

The nurses will be responsible for taking your blood pressure, heart rate, respirations, temperature and brief neurological assessment at least once a shift. An IV is placed on all patients in the EMU so that there is immediate access to give medication in the event of an emergency.

Specially trained EEG technologists will explain to you the monitoring equipment after they have placed the electrodes. A technologist will monitor you 24 hours a day for any seizure activity. With each seizure, medical staff—including physicians, EEG technologist and nurses—will come into your room to ask you questions and have you perform motor tasks. Medical staff will update you daily about any monitored events from the previous day.

Your medications may be adjusted during your stay to increase the chances of you having a seizure so it can be recorded by the EEG. There may be additional testing performed during the hospital stay, if indicated. Your physician will discuss this with you first. The nurses, EEG technologists and physicians work as a team to provide you with optimal care during your stay.

EMU frequently asked questions

How should I prepare for admission to the EMU?
An epilepsy clinic nurse will call a few days before your admission to get updates and provide you with further instructions. You may be asked to hold anti-epileptic medications; however, continue to take all other prescribed medications. Arrive at the hospital with clean hair, free of any hair products, including oils. Any hair weaves should be removed prior to admission to ensure proper EEG electrode placement.

Can I have visitors?
While it is not a necessity, family members are encouraged to visit often or stay when possible, as they are often helpful in recognizing seizures and providing support. There is a pull-out couch in the room if one family member or friend is planning to stay with you in the hospital. There are no visiting hours; however, children are not permitted at night under any circumstances. Pillows and blankets will be provided to guests, but guests are responsible for their own meals.

What kind of clothing should I wear?
Shirts you bring from home must be able to open completely from the front (for example, a button-down shirt or pajama top). Do not bring any clothing items that you must pull over your head. Tops should be short-sleeved, as you must have an IV placed in your arm. Hospital gowns and pajama bottoms will be provided to you if you prefer not to wear your own clothing from home, or in the event that a certain test requires you to wear hospital clothing.

What personal care products should I bring?
We will provide soap, a washbasin, Kleenex, baby shampoo, lotion, a toothbrush, toothpaste and a comb. You are welcome to bring any additional items that will make your stay with us more comfortable. If you have long hair, a brush or wide-tooth comb may be helpful to detangle your hair when the electrodes are removed. Hand sanitizer will be provided upon request.

What should I not bring?
Please leave valuables, including cash and jewelry, at home. We are not responsible for lost or stolen items.