Epilepsy Monitoring Unit (EMU)
Inpatient epilepsy monitoring for clearer answers and better care
Not all seizures are easily diagnosed or understood. Sometimes, outpatient epilepsy testing isn’t enough to capture the information your doctor needs to create an effective treatment plan for managing epilepsy.
If this happens, our doctors may recommend inpatient testing in the Epilepsy Monitoring Unit (EMU) at The Clifton Center for Medical Breakthroughs. Our EMU provides extended, multi-day epilepsy monitoring that gets you and your care team the answers you need for the most effective management of epilepsy.
What is the Epilepsy Monitoring Unit?
The Epilepsy Monitoring Unit at Penn Medicine is an 8-bed inpatient testing center that provides continuous 24-hour electroencephalography (EEG) with video monitoring. During your stay, we record your movements and behavior before, during, and after a seizure, where in the brain it starts, the type of seizure you experience, and how often it occurs. Our Comprehensive Epilepsy Center specialists use these insights to design more effective, targeted treatment plans for difficult-to-manage epilepsy.
Inside the EMU: What to expect during your stay
Before your stay at our Epilepsy Monitoring Unit (EMU), you may be weaned off seizure medications so our team can observe and record your seizures. Most people stay in the EMU for five or six days, though the exact length depends on your symptoms and needs.
When you arrive, a technician will attach electrodes to your head to monitor electrical activity in your brain. For some patients, our epilepsy care team may recommend stereotactic EEG (sEEG), which involves placing electrodes directly into the brain to record seizures and brain activity.
Specially trained doctors, nurses, and technologists are present in the EMU around the clock. If you have a seizure, they are there immediately to help keep you safe.
Why patients trust Penn Medicine’s EMU
People who choose us for EMU neurology testing find:
- Comfort and amenities: Every private room is large and spacious, with room for friends and family to visit. All rooms have interactive televisions that accept personal devices for video games and streaming. The screens also automatically identify care team members and remind patients of their daily appointment schedules and treatment goals.
- Safety and preparation: Before your stay in the EMU, our team will explain how to prepare and what to expect. To help capture seizure activity for monitoring, you may be instructed to reduce or stop anti-seizure medication. For safety, EMU rooms feature fall-resistant flooring, and you'll be supervised when out of bed and asked to use a bedside commode during your stay.
- A designated, around-the-clock team: Every member of the EMU team is specially trained in epilepsy monitoring. An on-site physician, epilepsy-trained nurse, and technologist monitor patients 24 hours a day, with technologists trained to quickly recognize seizures.
- Advanced continuous monitoring: Every EMU room is equipped with at least two night-vision cameras that record high-definition video from multiple angles to capture seizure activity. If a seizure occurs, a technologist can immediately activate a neurological assessment through the in-room interactive TV, helping our team collect critical seizure data 10 to 15 seconds sooner than most facilities.
Frequently asked questions
Most patients stay in our EMU for five to six days, but your stay may be shorter or longer depending on your individual diagnostic needs and how quickly we are able to capture the information required to make an accurate diagnosis and plan your care. A stay of over one week can occur and is not indicative of anything concerning.
Because the main goal of your EMU admission is to record uninterrupted EEG brain activity and video while you experience typical symptoms, the timeline ultimately depends on how your brain responds during the monitoring. Factors that can impact your length of stay include:
- The ability to capture clear events and high-quality data
- Medication adjustments
- Reactions to controlled seizure-inducing triggers, like sleep deprivation
- How well your vitals and post-seizure symptoms stabilize after restarting your medication before discharge
We want your stay to be as comfortable and convenient as possible while you are away from home. We recommend packing the following personal items:
- Clothing: Bring comfortable, loose-fitting clothing, ideally front-buttoning or zip-up shirts (instead of tops that must be pulled over your head), so the head monitor wires do not get disturbed. Pack comfortable socks or grippy slippers. Do not bring any clothing or sleep masks that cover your face.
- Entertainment and electronics: All patient rooms feature interactive televisions that work with personal gaming consoles, streaming devices, and HDMI connections. Bring your personal electronics, tablet, or handheld games, along with extra-long charging cords (6 to 10 feet) so you can easily reach your bed or chair. Note that usage of handheld electronics may be restricted at times to ensure there is no interference with the monitoring systems.
- Toiletries and hygiene care: Pack your preferred personal care items, such as a toothbrush, toothpaste, deodorant, brush, and body wash/lotion. If you wear glasses or contact lenses, bring them along with their protective case. You will not be using the shower during your stay, and hair products and hair washing is avoided as to not disturb the EEG leads that are connected to your scalp.
- Comfort items: Feel free to bring a favorite pillow, blanket, books, magazines, or hobbies (like knitting or crosswords) to pass the time.
- Medication: Bring all of your regular medications in their original prescription bottles, including both epilepsy and non-epilepsy medications. This allows our EMU specialists and nursing staff to verify your exact dosages and schedule and ensure there are no safety or interaction risks during your stay.
No. Continue taking all medications as prescribed by your doctor until you arrive at the EMU. Do not stop, reduce, or change any of your daily medications unless instructed by your physician. This can lead to unsafe or unexpected seizures or medical incidents.
Once you are admitted to the Epilepsy Monitoring Unit, your dedicated care team will evaluate your baseline brain activity and will lower or pause your medications in a safe and closely monitored medical setting.
Your assigned private room will be large and spacious enough to accommodate visitors each day. Review with our scheduling coordinator whether a family member is permitted to stay overnight based on hospital policy.
Additionally, there are plenty of hotels and housing options near the Clifton Center for Medical Breakthroughs, where our Epilepsy Monitoring Unit is located.
Once your monitoring is complete and you go home, your care team begins reviewing your test results to plan your next steps.
Before you leave, your doctors will make sure you are back on a safe medication schedule. If your doses were lowered during your stay, your team will restart or adjust them so you stay safe at home.
After you are discharged from the EMU, one of our epileptologists will study the continuous brain wave data and video recordings from your stay. This helps us pinpoint your exact seizure type and where seizures start in your brain. Reviewing several days of testing data takes time, with your full results typically ready in one to two weeks. You will meet with your doctor to go over the findings together at your next scheduled office appointment.
Based on your EMU results, your Penn Medicine doctor will work with you to create the best long-term care plan. This may include adjusting your daily medicines, trying new treatments, or discussing surgical options.
How your stay drives the next generation of epilepsy care
Penn Medicine’s EMU is an important part of our pioneering efforts in epilepsy research and clinical trials for patients with epilepsy and seizure disorders. In addition to providing high-level patient care, the EMU is an important collaborator with research laboratories in Penn’s academic, bioengineering, and clinical network. Access to these large stores of information advances the understanding of drug-resistant epilepsy and contributes to our scientists’ development of better treatments.
All surgical EMU patients have the option to allow us to store data from their EMU testing for use in research. For privacy, we remove all personal information from the data.
Patient stories
Actress returns to the stage after finding seizure relief
“Even though it had only been five years, epilepsy had taken away [the] career that meant so much to me.”
Epilepsy surgery gave Ann Rossi a new lease on life
“I was lucky if I could hold on to a thought for more than a few seconds. Now I’m retaining information for a couple of weeks. I’m having a hard time describing this experience as anything but life-changing.”
A tiny laser gave one patient relief from lifelong seizures.
"Minimally invasive surgery with lasers allows us access to areas [of the brain] that were traditionally not accessible in many patients."
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