Epilepsy is the most common neurological disorder in childhood. It is a heterogeneous disorder, meaning each case is different and can include a wide variety of seizure types, triggers, and clinical presentations.

There isn’t a one-size-fits-all plan for management, so it’s important we allow each child’s case to guide what is best. Many of the interventions and appointments we incorporate into the care of your child are to help us better understand their specific needs throughout their medical journey, recognizing that even these may change as time progresses.

Who are the people on my healthcare team? Your healthcare team consists of pediatric trained epileptologists, neurologists, neurosurgeons, neuroradiologists, neuropsychologists, child life specialists, EEG technologists, and specially trained nurses. Each patient and their caregivers are key members of this team as well. The caregivers are the child’s best advocate and most reliable resource to help us find the right treatment plan. Vigilance for treatment-emergent adverse effects is very important.

What is the Epilepsy Monitoring Unit? The Epilepsy Monitoring Unit, commonly referred to as the EMU, has hospital-like rooms equipped with special equipment for continuous monitoring of your child’s brain activity.

A diagnostic test called an electroencephalogram (EEG) provides the healthcare team with an understanding of what is happening in the brain. It records the electrical activity in the brain and can show patterns that may be normal or abnormal. While it can be done as an outpatient, video EEG includes video and audio recording that captures what is happening before, during, and after a seizure that may not be captured if there is only a short stay.

The EMU utilizes both continuous EEG and video EEG monitoring, and patients will stay anywhere from overnight to five days depending on their seizure syndrome.

Why is my child being referred to the EMU? After a clinic visit, your provider may refer you to the EMU for a variety of reasons. These include specifically characterizing the events your child is experiencing, determining their seizure type, assessing how well medications are working, and evaluating the best treatment options for your child. The goal is to “capture” on video and audio along with the EEG your child’s seizures and best characterize the seizure type. These details are dependent on each child’s specific case as we attempt to navigate their journey and find what treatment is best for them.

What can I expect during my child’s stay? After your child’s admission is complete, a trained EEG tech will come in and begin the process of placing the electrodes on your child’s head. The electrodes are attached with a special type of glue that can’t get wet.

Once this is complete, they will review the whole process and in particular the event button with you and your child. Either of you can push this button if you feel a seizure coming on or if you see one occurring. This will tag for the doctor the place to look to see the relationship of the seizure with the EEG. Your child will be monitored continuously by trained nurses and EEG techs.

The healthcare team may use tactics to trigger seizures in this controlled and safe environment. Remember, this is to help us identify your child’s specific needs and formulate a management plan that’s best for them, as no two cases are alike. These tactics can include use of flashing lights, heavy or rapid breathing, interrupting sleep, and/or reducing or stopping medications. Note that if your child’s medication is reduced or stopped, we may need to place an IV as a precaution so that we can quickly and effectively stop a triggered seizure.

Your child’s seizures can be scary but know they are occurring in a controlled and safe environment with specially trained staff, and that capturing their specific seizures on an EEG is what will allow us to individualize care based on what is best for your child at that time during their medical journey.

The EMU is located directly adjacent to the Pediatric Intensive Care Unit (PICU), with their team always available and ready to assist if extra hands are needed.

What is the goal of the EMU stay? At the end of your child’s stay, your healthcare team is hoping to find what is causing your child’s seizures, where in the brain their seizures are occurring, if and what medications are working to control their seizures, and evaluate what the best treatment options are for your child at that point in their journey.

Once your results are analyzed, they may also be presented at our weekly epilepsy conference. This allows your child to receive a comprehensive, multidisciplinary evaluation.

You will schedule a follow up with your provider after your stay to review the results and go over the individualized recommendations from your brain team.

Helpful tips when coming to the EMU

• A parent/guardian needs to stay with a child during the entirety of the stay.
• Shower before coming in for the test because once the electrodes are on, they can’t get wet.
• Wear a button-up or zip-up shirt (gown can be provided).
• Bring comfort items, such as a blanket, and things to stay busy, like games or a book.
• Electronic items can be used but not while plugged in because it can interfere with the EEG recordings.

Learn more about our EMU here, or call 855-WVU-CARE (2273).