Unlocking Mysteries of Epilepsy is Goal of New Monitoring Unit

Emory University Hospital’s state-of-the-art Epilepsy Monitoring Unit (EMU) helps patients better identify the source of epileptic seizures, which in turn, can lead to more effective treatments and outcomes.

Epilepsy, which takes many forms, can result in severe physical convulsions to loss of consciousness or even short-term memory loss.

More than 40 million people currently suffer from epilepsy, a neurological disorder that causes abnormal electrical activity in the brain resulting in recurrent seizures. The condition affects children, adults and seniors. It can be genetically present from birth or caused by a head injury, brain tumors or strokes. In many cases the cause cannot be discovered.

The newly renovated unit allows for continuous video and EEG (electroencephalography) monitoring of electrical activity in the brain. A standard EEG test typically lasts 30 minutes and only offers a brief snapshot of a brain’s activity within a limited time frame. However, continuous monitoring can improve diagnostic accuracy when the diagnosis of epilepsy, particular seizure type or location of onset is not clear by routine EEG recordings.

According to Suzette LaRoche, MD, director of neurophysiology at Emory University Hospital there are many different types of seizures a patient with epilepsy may experience. Accurate diagnosis of seizure types aids in the appropriate selection of effective medications and possible surgical treatment options.

“Accurate diagnosis of the correct seizure type and pinpointing exactly where in brain seizures originate can help us to determine therapeutic options which may include one or a combination of drug therapy, surgery or even a device similar to a pacemaker called a vagus nerve stimulator,” explains LaRoche.

“For many epilepsy patients, the only way to offer better treatment is to monitor them and study what occurs during an actual seizure,” says LaRoche. "While experiencing a seizure is not exactly thought of as desirable, the EMU is the only place where seizures can be witnessed -- allowing us to collect as much information as possible about them.

“The more we can learn about an individual patient’s seizures, the better our chances of being able to offer better seizure control and maybe even reduce or eliminate certain medications that cause severe drowsiness, impaired thinking or other adverse physical effects,” notes LaRoche. “This is probably the only place that patients actually hope for and want to have a seizure.”

The unit, which officially opened in April, is part of a 24-bed neurology and neurosurgery wing within Emory University Hospital. The 10-bed EMU unit includes a patient activity room, satellite nursing station, an EEG tech control room equipped with video monitoring equipment and the EEG application and reading room.

Not only does the unit combine the latest in technology and medicine, it also relies on a little help from man’s best friend … the dog. The EMU is the only unit at Emory University Hospital that welcomes trained assistance dogs making regularly scheduled visits with patients, according to Unit Director George Fraser, RN.

“We have partnered for almost a year now with Canine Assistants, a local organization that trains and provides service dogs for children and adults with physical disabilities or other special needs, including epilepsy,” says Fraser. "The visitations are really a special opportunity for some of our patients - and staff - to bond with the animals. Some of the animals are bred as seizure response dogs, which can be trained to remain next to a person during the course of a seizure, locate help if others are nearby or even retrieve a phone if a patient is in the process of or expecting to experience a seizure.

“Having these visits truly makes this environment more home-like and helps us to brighten a patient’s stay, and it truly differentiates us from a standard clinical care experience by making our patients’ experience more family and community-oriented,” says Frazer.

Brenda Free of Savannah, Ga., recently made her second visit to the unit in the hopes of pinpointing the causes of her epileptic seizures.

“I have suffered from epilepsy since the birth of my first child more than 25 years ago, and have experienced everything from lapse of memory to severe physical injuries such as a repeatedly dislocated shoulder resulting from seizures,” Free explains. "For years, I took medication, which helped some. But I never really wanted to believe or face the reality that the seizures I was experiencing were really epilepsy … and so I did my best to ignore and hide it as best I could.

“I had for so long neglected to properly monitor my condition and consistently take the medications that in turn made me so tired and lethargic, that I eventually lost my job,” she says. "I was either tired all of the time, or suffering from the seizures when I didn’t take my medication.

“I knew that it was time to take control of my condition and not ignore it or sleep it away,” says Free. “After consulting with my doctor and doing a lot of research on the web, Emory came up. Now, I am like many other epilepsy patients who come to Emory just hoping to have a seizure, because that is the only way to unlock what has to this day been a mystery.”