What is the Epilepsy Monitoring Unit (EMU)?

What is the Epilepsy Monitoring Unit (EMU)?

The EMU is a specially equipped room used for precise diagnosis of seizure-like episodes.

3 things are continuously recorded in the EMU:

1. EEG (Electro-Encephalo-Graphy): This records the brain's electrical activity
2. Video
3. ECG (Electro-Cardio-Graphy): This records the heart's activity

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What are the types of seizures?

There are 3 main kinds of seizures:

1. Focal — These seizures start in one part of the brain
2. Primary Generalized — These seizures start all over the brain in an instant
3. Non-Epileptic attacks — These attacks are not caused by epilepsy. For example, stress or heart problems can cause Non-Epileptic attacks

Does an EMU admission enable precise treatment?

Yes, Definitely! Here are 4 examples:

1. We can precisely diagnose the type of your attacks. For example, regular seizure medications do not work for stress-related seizures. Counselling and stress reduction are very effective
2. It helps to exactly measure seizure activity. Medications are increased or reduced accordingly
3. If your (or your child's) EEG is very active at night, steroids need to be given to control seizures
4. It tells us which part of the brain is bad. If you are not responding to medications, Epilepsy Surgery can remove this bad part

What will my room look like?

The EMU rooms are comfortable and safe. The exact facilities depend on the room you choose. There will be an EEG machine in the room. This machine has 1-2 cameras and a microphone. The patient bed has a curtain. You can use this for complete privacy. Please use it only when required, such as changing clothes.

In rare cases (for example, if you have very long seizures), monitoring is done in the Neuro-ICU instead.

What services are included in the cost?

The cost of monitoring depends on the type of room that you select. The all-inclusive costs include:

• Room Charges
• EEG recording and interpretation charges
• Neurologist consultation daily
• Daily Nursing assessments
• Bed at night for the caregiver

Regular anti-seizure medications are given from the hospital store. This is usually a minor expense.

Additional services are charged separately:

• Special consultations: For example, Psychiatrist or Cardiologist
• Additional testing — such as MRI or SPECT scans

How should I plan my admission?

First, visit the EEG department on the 1st floor. Then, visit the admissions department on the ground floor. They Will

1. Give you an expense estimate. This depends on the duration of stay & additional testing
2. Contact your insurance company

What should I do on the day of admission?

1. At home: Wash your hair thoroughly. Don't apply oil or gel to your hair
2. Keep taking medications as per schedule, unless otherwise advised
3. Bring your referral note & all other medical records
4. Bring things to help you pass your time such as movies, puzzles or books
5. Go to the admissions department (ground floor)
6. Then, go to the allotted ward for EMU monitoring

Where is the EMU at Nanavati Max Hospital located?

The EMU is located in the main hospital building. After walking to the allotted ward, talk to the nurse-in-charge, who will help you get settled.

What happens after admission?

You will change into a comfortable hospital gown. A technician will stick the head EEG electrodes, the chest ECG electrodes & start the recording.

Every day, multiple members of the team will update you. Please feel free to ask questions.

Discharges are planned a day in advance. Before discharge, the team will discuss captured events and further treatment steps with you.

Can my family stay with me?

Yes! We require that a family member be present in the room at all times. Extra meals and a smaller extra bed at night are included.

What should I (or my family) do if I have a seizure?

You will be given a "seizure button". Both you and your family members can use it.

When you press the seizure button, it does two things:

1. It marks the EEG recordings with a special mark that says "Patient Event"
2. It calls the nurses into your room. They make sure you are safe. They will also test your thinking, memory, speech, and limb movements

Press the seizure button even for these occasions:

• If you have your typical aura or warning
• If you felt something strange happen, but are unsure
• If you feel very tired or sore in the morning - Press the seizure button and say loudly that you possibly had a seizure the previous night

After pressing the button, describe your symptoms loudly. For example: "I was very anxious. My right arm was tingling".

How long will I be in the EMU?

Ideally, all types of events that you are having should be recorded. We try to record 2-3 events of each type. The duration of monitoring depends on seizure frequency. Here is an approximate guide:

What if I don't have a seizure?

If your seizure frequency is low, we may try to provoke a seizure by:

• Reducing the dose of your anti-epileptic medications
• Requesting you to stay awake at night
• Stimulating your brain by using flashing lights
• Breathing hard and fast

The majority of patients have a seizure with these measures. A minority of patients still do not have seizures during admission. This is called a "non-diagnostic EMU admission".

When do I get my final report?

Our team will discuss the evaluation results with you before discharge.

The final report will be couriered to you in 2-3 days. Follow up in the OPD will be 4-5 days after discharge. There, you can discuss your report and plan further treatment.

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