Epilepsy Monitoring Unit

EEG
The Adult Epilepsy Monitoring Unit (EMU) is a specialized 8-bedded inpatient unit located on the 5th floor of the new UFHealth Neuromedicine Hospital. The EMU is where the single most important investigation is performed for patients with seizures that are difficult to treat, or in whom an accurate diagnosis proves difficult to establish on an outpatient basis: the recording of seizures, as well as normal waking and sleep over several days under continuous EEG and video surveillance (video-EEG; VEEG). We perform over 300 EMU evaluations yearly, with 5-8 patients evaluated each week. In general baseline EEG is recorded for a period of a few hours (sometimes up to 24 hours) where no changes are made; antiepileptic medications are then carefully reduced in a staged manner to provoke the patient’s habitual seizure. Following the recording of sufficient seizures, anticonvulsant medications are reintroduced (and sometimes changed, depending on the individual case), and the patient discharged when the treating team determines that they are back to their baseline condition and stable. Analysis of the recorded data determines the seizure type (technically the epilepsy ‘electroclinical syndrome’) that then guides the longer term management of the patient.

All EMU rooms in the UFHealth Neuromedicine hospital are private and equipped for a high standard of patient comfort. A family member is encouraged to stay with the patient throughout their stay. The treating time rounds on a daily basis in the mornings, updating the patient and their family of their day-to-day progress. One or more members of the team are always available for more in-depth discussion at other times of the day.  Upon discharge, patient follow-up arrangements are made or confirmed. Any necessary paperwork or medication refills can also be taken care of at this stage. A detailed report is created and sent to the patient’s primary care physician, the referring neurologist and the clinic/ outpatient team.

Questions regarding the Epilepsy Monitoring unit – or any other aspect of the UF Comprehensive Epilepsy Program – should be directed to

Email: UFCEP@neurology.ufl.edu

Phone: (352) 273-9570

Information for Patients

You will be admitted to the Epilepsy Monitoring Unit (EMU) at the Neuromedicine Hospital, Floor 57. Our large modern rooms are all private  and equipped for a high standard of patient comfort. Each monitoring room has special seizure-monitoring equipment and ceiling-mounted cameras. You should prepare for a 3-5 day admission. Sometimes your admission may be a little longer depending on how long it takes to record seizures.

Many patients find it challenging to be confined to a single room for several days. The prospect of having medications deliberately reduced to provoke seizures can also be stressful. Yet, video-EEG monitoring for recording of seizures remains the best test there is for accurately diagnosing the seizure type and overall disease state of the patient. We ask you to bear with us during your testing period. Please let the team know if there is any way we can make your experience more comfortable.

How to prepare

You will have received paperwork including direction on where to park and where to report to for your admission. The nursing staff will orient you to your room and will explain the use of the nurse-call system, seizure monitoring equipment and information about the hospital routine. We are welcome (and recommended) to have a companion stay with you during your entire hospitalization. Our rooms are all large with private bathrooms and have a separate bed for patient companions.

During the test

The medical team and nursing staff will introduce themselves and once more take a detailed history of your seizures. You will have an IV placed should we need to give fast-acting medications to control seizures; side rails of your hospital bed will be padded to prevent possible injury during a seizure. You may have lab work at the time of admission, and further lab tests as necessary during your stay. Technical staff will then connect you to video-EEG monitoring which is a continuous recording of your brain waves and your video. EEG leads are checked daily.

During your stay, your seizure medications will be slowly tapered in order to provoke and record seizures; you may also be sleep-deprived, which is another way to provoke seizures. The epilepsy team will round daily, when you will have the opportunity to ask the team about the information gathered in the prior 24 hours.

You are permitted to take a sponge bath but showers are not permitted. Please do not smoke (nicotine patches are provided if needed) or chew gum or eat hard candy. We will provide non-skid grip socks for when you get out of bed.

After seizures are recorded and/or when the treating team determines that sufficient information about your seizure disorder has been recorded, your medications will be restarted and you will be prepared for discharge. Prior to discharge, and depending on the results obtained, you may have more tests organized as an outpatient.

Results

You would normally follow up in the outpatient clinic with the doctor who requested the EMU testing. This will be a further opportunity for you to discuss the results obtained, and what those mean for the treatment of your condition.