The Will Sally Epilepsy Video/EEG Monitoring Unit (EMU), located in the UCSD Thornton Hospital, was dedicated in the fall of 1994. This five-bed unit was upgraded in 2004.
- It uses state-of-the-art digital equipment and techniques to evaluate the patient with a seizure disorder.
- The EMU feauters private and semi-private rooms with digital cameras and remote control observation by trained staff.
Up to 128 channels of EEG can be recorded digitally, and stored directly on the video corresponding to the patient's behavior at that moment. Data is received and anayalzed in a nearby control staion. Patients with medically intractable seizures are admitted to the Epilepsy Monitoring Unit for continuous EEG and video recordings in order to determine the type, site of onset and frequiency of the seizures. If seizures do not occur spontaneously, they may be encouraged by taping anticonvulsant medications or restricting. Identifying the exact focus of the seizures is critical in determining the most effect course of treatment.
In the initial telemetry, the EEG recorded from extracranial electrodes are evaluated in conjunction with other diagnostic techniques such as brain imaging. The hospitalization usually lasts three to 10 days. After the patient is discharged, the UCSD neurological team analyzes the data and makes its recommendations to the referring phsycian. Properly diagnosed, epilepsy can be often controlled with appropriately prescribed medication. In refractory cases, surgery may be the preferred option.
In some instances of refractory seizures when surgery is indicated, extra-cranial telemetry may be sufficient for localization of the epileptic focus and planning the surgical approach. In other instances, a second admission for telemetry via intracranial electrodes is necessary for more precise localization. Intracranial electrodes are placed by the neurosurgeon in the Operating Room under anesthesia.
These may be:
1. Foramen ovale electrodes, which are wire electrodes placed in the medial cranial fossa through the foramen ovale;
2. Subdural strip electrods, which are Band-Aid-sized strips of flat electrodes placed over the brain via burr holes;
3. Subdural grids that require a craniotomy for placement.
The electrodes are removed at the conclusion of the telemetry. The hospitalization usually lasts 3 to 10 days, or long enough to record typical seizures, and verify that there is one seizure focus.
ADVANCE For Nurses Features UCSD's Epilepsy Monitoring Unit
In July 2006, UCSD's specialized epilepsy monitoring unit was featured in ADVANCE for Nurses. Read the featured article, Searching Seizure.