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Surface Electrodes, Video-EEG Monitoring
Patients usually undergo a five to seven day admission to the Epilepsy Monitoring Unit (EMU) for a comprehensive, non-invasive, differential or pre-surgical evaluation. Patients have electrodes placed on their heads with collodion by a registered EEG technologist. The electrodes are then connected to a continuous EEG and video recording system. The equipment is used to obtain continuous recordings of seizures. The events or seizures provide information for the epilepsy team and help determine the most effective course of treatment and management.
During the process, medical professionals carefully taper or reduce anti-epileptic medications and patients are asked not to sleep to increase the likelihood that the patient will have a seizure. As a safety precaution, an intravenous catheter is placed in an arm vein to deliver medications immediately if seizures become too frequent. It is ideal to record several typical seizures to determine where the seizures originate from. During testing, it is necessary for the patient to stay confined to the bed for seizure capture (video) and for safety. Once the data has been collected, medication is increased to appropriate levels so that the patient can be discharged from the hospital.
It is typical to have other procedures such as magnetic resonance imaging (MRI) or other localizing procedures scheduled throughout the patient's stay at the hospital. If patients are being evaluated for possible surgical intervention, then other tests such as SPECT, PET, sodium amytal test for speech and memory localization are scheduled. It may take several weeks to analyze all of the data collected from EMU Video-EEG stay. Patients may be asked to participate in additional testing to provide more data. All of the tests will be discussed andg reviewed by the team with the patient during a follow-up clinic visit to determine whether a patient is a surgical candidate or requires further evaluation or testing.
Inducing Seizures During Phase I
Because the hospital stay removes patients from their normal environment, there is the possibility that the frequency of seizures will subside or not occur during the hospital stay. There are a variety of options for inducing seizures, including tapering off anti-epileptic medication, sleep deprivation, hyperventilation and photic stimulation that can be used to bring about seizures. Stressing the brain can often induce seizures. Patients should be prepared to share information that may be useful in triggering seizures. There is no need to be embarrassed or intimidated. The primary goal of the evaluation is to capture seizure events during the stay.
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