Epilepsy Monitoring Unit
If your child is experiencing seizures or has been diagnosed with epilepsy, he or she may be admitted to the Epilepsy Monitoring Unit (EMU) at NHRMC Betty H. Cameron Women's & Children's Hospital for evaluation using a combination of electroencephalogram (EEG) testing and video/audio recording.
Reasons for Admission to Epilepsy Monitoring Unit
There are two common reasons for admission to the EMU:
- To record an episode in order to determine whether the episode is a seizure
- To record brain waves (and often seizures) in a patient with known epilepsy in order to guide treatment
How long your child will need to remain in the EMU will depend on your child's condition and the recommendation of his healthcare team. Seizures and events are unpredictable, making it difficult to obtain the data needed for diagnosis. Also, the goal of each child’s admission is different. Some children are here to capture one event while others need to have several events recorded on video-EEG.
What to Expect Before, During and After Admission
Being in the hospital may be stressful for both you and your child. Our team understands your concerns and are available to answer your questions. Knowing what to expect can help lessen your anxiety and help you explain to your child what will happen while he or she is admitted.
- Your child will undergo EEG monitoring. EEG wires will be attached to your child’s head. The EEG data is recorded continuously during this time. The wires are long, and your child will be able to move around the room. Patients do not need to remain in bed.
- Your room will undergo video surveillance. The video is linked to the EEG, so we can compare your child’s brain waves to their behavior and movements. Please note the location of the camera in your room. If your child has an episode of unusual movements or a seizure, please do not block the camera or we will not be able to see your child on video.
- The EMU is a multidisciplinary team consisting of many specialties. Depending on the needs of your child, the team may include the neurologist, EEG technologists, pediatric hospitalist physician, nurses, and other specialists. A Child Life Specialist will participate in your child’s care to help coordinate recreational and bedside activities.
- A day or two before your scheduled appointment you will be contacted by a staff member in the EMU to confirm your appointment.
- If you are going to be later than your scheduled time, you must call the EMU directly at 910.667.3770 so we can coordinate your arrival time with other patients. If you are late and haven’t called us in advance, we may need to reschedule your admission.When you arrive to the Betty H. Cameron Women’s & Children’s Hospital main entrance you will report to the reception area. They will call the Pediatric floor to alert the staff that you have arrived, and you will be instructed to proceed to the 2nd Floor.
- You will be greeted there by the Health Unit Clerk who will show you to your room, and gather medical information about your child. You will be introduced to the EEG technologist, who will show you the equipment and provide you with an opportunity to ask questions.
- Once your child has been admitted to the floor, the EEG electrodes will be applied by an EEG technologist and the EEG and video data will start to be collected. The monitoring equipment simultaneously records the brain waves, video and audio of your child.
- Your child must remain still and in a flat position for a short period of time for the electrodes to be successfully and accurately applied. Sometimes we use a medical immobilizer to keep your child from moving and to ensure their safety.
- We apply the electrodes with an adhesive called collodion. The collodion is dried with air. Once the electrodes are applied, gauze is wrapped around your child’s head to keep the electrodes in place. Our EEG technologists have special training in applying the electrodes and head dressing to children. Some children may find the process scary at first, but there is no pain with the procedure. We work closely with Child Life Specialists to make your child as comfortable as possible.
- If your child has a seizure or suspicious event, you must:
- Try not to block the camera. Seeing the child during the event helps us best understand it.
- Loudly describe what you are seeing during an event. For example, “my child is staring” or “I see shaking of the left arm.” This helps us understand things we may not be able to see on the video. Audio is being recorded during the monitoring.
- Push the event button. The EEG technologist will show you a button in your room. Pushing this button marks the event on our recording, and allows us to find the event. If you don’t push the button, we may not be able to find the event of interest.
- Write down the time of the event and a detailed description of what you see. The EEG technologist will provide you with a paper to use to record details about the event.
You know your child best and want him or her to be comfortable during admission. We ask that one adult stay with your child during the admission to help identify the spells or seizures of interest. When you need a break from your child’s room, please let us know so that the nurse can coordinate alternate coverage.
- We ask that when your child is awake that you remain awake to help identify the events.
- You don’t need to stay awake when your child is asleep.
- We encourage you to bring favorite toys, books, and school work.
To help pass the time, we also have a TV and a Xbox gaming system in every room. We have a large selection of toys, board games and crafts in our playroom that we can bring to your child.
Parents have 24-hour visiting privileges, and every room has one sleep sofa.
Siblings are not permitted to stay overnight. We discourage you from bringing infant visitors as they may be exposed to viruses that may cause them to become sick.
You may notice marks on your child’s head once the electrodes are taken off. The severity of the marks depends on the length of the time the head was being monitored and your own child’s skin texture.
Fair or thin skinned heads tend to have areas that have the greatest percentage of indentations left behind. You may notice the shape of the gold electrode on the forehead area, redness, puffiness and even slight blisters/scabs.
This is all from having the electrodes on the head and being wrapped. No air gets in. This is normal. The longer your child's study, the more severe the area may look.
- Do not rub the irritated area
- Gently blot dry
- We suggest using Neosporin on the areas in question
The marks can take up to two weeks to vanish. Of course if you still have concerns, please call your pediatrician.