What to Expect in an Epilepsy Monitoring Unit

What is an Epilepsy Monitoring Unit?

An epilepsy monitoring unit (EMU) is an inpatient unit at a hospital that allows epilepsy specialists to observe a patient’s episodes concerning for seizure while they are undergoing continuous electroencephalography (EEG) monitoring with video recording to better understand how changes in brain electrical activity relate to the symptoms the patient is experiencing. During monitoring, physicians can identify whether events of concern are seizures as well as the precise area of the brain in which seizures are occurring. This information can be useful in determining whether a patient is a candidate for different treatments such as epilepsy surgery. EMUs are usually a part of comprehensive epilepsy centers.

What to Expect in an Epilepsy Monitoring Unit

Patients are admitted to the EMU and may stay for an average of 1-7 days, depending on the patient’s condition, while undergoing tests to characterize their seizures and determine their treatment plan. Sometimes physicians will have patients decrease their antiseizure medication doses before or during an EMU admission to make it more likely that the patient will have a seizure while on EEG in the hospital. The clinical team in the EMU will always make sure rescue medication is available in case a patient has a long seizure or too many seizures.

Types of Monitoring

Video-Electroencephalogram (EEG) - Allows physicians to record a patient’s brain electrical activity before, during, and after a seizure with the EEG. A video-EEG makes a video recording of the patient’s behavior to make interpretation of the EEG more accurate. EEG is not invasive, does not change the brain in any way, and does not deliver any electrical stimulation. It is performed with electrodes attached to the surface of the scalp to measure the electrical activity of the brain.

Video Monitoring with Night Vision Capabilities - Allows physicians to view physical symptoms, such as jerking movements and staring spells, even while the patient is sleeping in the dark.

Other Monitoring - Other diagnostic tests may be done including lab work, a magnetic resonance imaging (MRI), neuropsychological testing, and single-photon emission computerized tomography (SPECT) scans.

Additional Resources

For more details, check out these helpful resources:

• American Epilepsy Society: Epilepsy Monitoring Units
• Cedars Sinai: Epilepsy Monitoring Unit
• Children’s Hospital of Philadelphia: Epilepsy Monitoring Unit (EMU)
• Children’s Mercy Kansas City: Your Experience at the Epilepsy Monitoring Unit