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Epilepsy Monitoring Unit

Epilepsy Monitoring Unit

Children's Hospital of Pittsburgh of UPMC’s Epilepsy Monitoring Unit (EMU) is one of the most technologically advanced in the nation. Each of the eight private rooms in the EMU is fully equipped with state-of-the-art EEG equipment, video monitors and intercoms to ensure instant communication with the EMU techs and nurses. The Command Center is staffed 24 hours a day, seven days a week by EEG techs. Our patients receive individualized, customized treatment and personal care by our techs and nursing staff.

What is the Epilepsy Monitoring Unit?

The Epilepsy Monitoring Unit (EMU) is a specialized 8-bed unit within Children's Hospital of Pittsburgh of UPMC where children’s seizures are evaluated, monitored and recorded using digital EEG monitoring and neuroimaging studies.

Patients may stay in the EMU for several days while receiving continuous video EEG monitoring, which records the electrical impulses from the brain that can cause seizures. This activity is monitored continuously by the EMU Command Center. The EMU is staffed by nurses, technicians, and epileptologists who are experts in epilepsy, and dedicated to the personal care and comfort of each child.

Who Gets Admitted to the EMU?

Patients admitted to the Epilepsy Monitoring Unit (EMU) include children and teens with events that may not yet be diagnosed as epilepsy, or who have had a change in their seizure patterns. Patients with intractable epilepsy (Phase I) are those whose epilepsy does not improve with medications.

Diagnostic Video EEG (VEEG)

A patient admitted for a diagnostic video EEG (VEEG) may have a seizure disorder that has not yet been diagnosed as epilepsy, or their epilepsy has worsened. They will be monitored in the EMU so that their events can be captured on the EEG and a diagnosis can be made or confirmed.

Patients typically have a consultation with a Children’s Hospital neurologist to determine if admission to the EMU will be helpful in diagnosing the child’s condition.

Phase I

A patient is referred for a Phase I if they have been diagnosed with epilepsy and have not had success with other epilepsy treatments. Each patient is given an individualized treatment plan that may include any or all of the following tests:

During your child’s stay in the EMU, he or she may need to taper their anti-seizure medicines or stop taking them to allow for seizures to occur. Other triggers, such as sleep interruption or exercise may be used to bring on a seizure.

After the Phase I evaluation is complete, the EEG, SPECT, and other studies are reviewed by multiple physicians, residents and fellows, who all provide their expertise in diagnosing the child’s condition and make recommendations on treatment.

Phase I Outcomes

A child can have one of three outcomes after completing their Phase I evaluation in the EMU:

  1. The child is taken directly to surgery where a portion of the brain will be resected.
  2. No surgical option is possible, either because the abnormal activity cannot be confined to one area of the brain, or because the abnormal part of the brain is too close to the area responsible for motor or language function.
  3. A Phase I patient may be advanced to Phase II, where more information is needed before surgery can be scheduled.

Phase II

A craniotomy is performed and subdural grids, which are electrodes embedded in a strip of flexible material, are placed directly on the surface of the brain. The child will spend the first night in the Intensive Care Unit (ICU) until his or her condition is stabilized. The cables from the grids are attached to a portable EEG, and their brain activity is monitored. This tells the physician where the seizure activity is coming from. Once stable, they will be taken to the EMU for 5 to 14 days. The child will have continuous Video EEG (VEEG) monitoring during the length of their stay in the EMU.

Learn more about how subdural grids help surgeons identify which area of the brain to resect. 

Last Update
April 16, 2014
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Last Update
April 16, 2014
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