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EEG Monitoring for Epilepsy

This video shows the experience of a video EEG monitoring stay at UC San Diego Health.

The Epilepsy Monitoring Unit at UC San Diego Health

The Epilepsy Monitoring Unit (EMU) at UC San Diego Epilepsy Center is a state of the art seizure evaluation center. At the EMU, patients’ seizures are evaluated through continuous video and EEG recording in a hospital setting. We do this to determine type of seizure, site of onset, and frequency of seizures. Specifically, the EMU enables us to analyze the electrical and behavioral components of each seizure in order to verify a patient’s diagnosis and improve his or her treatment plan.

Video-EEG monitoring is critical to determining if surgery could be an effective treatment for those whose seizures are not controlled with medical therapy.

Every evaluation is tailored to the patient’s individual history. We often try to record 3 to 5 seizure examples to determine their type and location. The seizures are evaluated in a hospital setting under conditions of maximal patient safety. We are interested in recording natural seizures; we do not give agents to induce seizures. Most patients respond to gentle tapering of their regular seizure medications combined with sleep reduction.

EEG Seizure

EEG showing onset of temporal lobe seizure

Noninvasive EEG electrodes are applied to the scalp and an IV is started to allow for quick treatment if necessary. Patients are recorded day and night with a continuous video camera, except when in the bathroom, in order to analyze any seizure activity. In addition, patients are not permitted to leave the EMU during the evaluation except for emergencies.

Because of tapering medication and sleep reduction, seizures may be more frequent or stronger than usual. A special team of professionals work closely with patients during their stay in the EMU and the hospital setting provides for maximal patient safety. If seizures become too long, strong or frequent, medication is given via IV to treat seizures quickly.

The average length of hospitalization in the EMU is 3-5 days, but many patients are asked to stay longer to record a good sample of seizures.

We encourage patients to have a friend or family member with them in the EMU to keep them company and to help identify events that could be seizures. A trained technician or nurse is present at all times to observe the patient on closed circuit video. As soon as a seizure is observed to start, the patient, the companion or the seizure technician may press an alarm to signal nursing staff to come to assess and assist the patient. Epileptologists review the EEG daily to look for “silent” seizures that may have gone unnoticed during the prior 24 hours, including sleep.

Referring physicians will receive a report of the detailed findings from the video-EEG monitoring.

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