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SUNY Downstate Comprehensive Epilepsy Center

Epilepsy Monitoring Unit (EMU)

Dr Grant with EMU patient

The Epilepsy Monitoring Unit (EMU) is a dedicated 8-bed unit located on the 7th floor of University Hospital of Brooklyn. Specialized staff and equipment provide round-the-clock monitoring of the patient's behavior and brain waves (EEG). EMU rooms have built-in video cameras with microphones, cable connectors for EEG, and alarm buttons for when a patient has a seizure or spell. Most patients are in the EMU for 3 - 5 days, but occasionally stays up to 10 days are needed, especially in patients being evaluated for epilepsy surgery.

The EEG (electroencephalogram) records a patient's brain electrical activity, while the patient's movements are simultaneously monitored via video equipment. This equipment is linked by a computer network to facilitate rapid, real-time examination of the recordings by epilepsy experts.

Benefits of EMU Monitoring

There are 3 main reasons for a doctor to recommend a patient be admitted to an EMU.

  1. To absolutely determine whether a patient's spells are epileptic seizures, or are from some other cause.
  2. To determine what kind of seizures a patient has. There are different types of epilepsy and several types of seizure, and these respond differently to medications.
  3. To determine precisely where in the brain seizures start, in order to evaluate whether brain surgery could eliminate or reduce the patient's seizures (in cases where seizures are not controlled by medicine).

Sophisticated Diagnostics

An admission to the EMU is a kind of medical test, one that requires special equipment in a hospital setting.

The EEG recording provides information about the brain's electrical activity, and is the best way to detect the abnormal electrical activity of epileptic seizures.

The video recording can help clarify certain situations, such as instances in which a patient has physical signs of a seizure before the EEG activity is abnormal–this may suggest that seizures begin in deep parts of the brain. A patient's behaviors during a seizure also help doctors determine the type of seizure, and what parts of the brain are involved.

The test is complete when enough of the patient's spells or seizures have been recorded to answer the question that the doctor had when he recommended EMU admission. Every day, an epilepsy specialist reviews the recordings, paying particular attention to any seizures or spells. The doctor may make adjustments to the patient's medication during the testing process, often to help bring out more seizures or spells for observation.

After the monitoring is finished, the neurologist will prepare a comprehensive report about the recordings, which will be sent to the doctor who recommended the test.