Epilepsy Monitoring Unit Features

• Six continuous EEG monitors with synchronized video recording, for the accurate diagnosis and classification of seizures.
• A patient/family day lounge on the unit, allowing the patient undergoing long-term monitoring to leave their hospital room and relax in a pleasant environment. VCR, games, puzzles, books and an exercise bicycle are available.
• A control room or unit containing the latest in EEG monitoring equipment staffed by a registered EEG Technologist.
• Round-the-clock nursing care provided by registered nurses.

Epilepsy Monitoring Unit Staff Members
The EMU focuses on a multidisciplinary approach to epilepsy. It is staffed by specialists trained in the evaluation, treatment, and education of patients with epilepsy and related conditions. Personnel, and their respective functions, include:

• Neurologists, who guide the evaluation of patients, interpret the results of diagnostic studies, and plan treatment strategies. The EMU is directed by a Neurologist/Epileptologist who is certified by the American Board of Psychiatry and Neurology and the American Board of Clinical Neurophysiology.
• Neurosurgeons, who place intracranial EEG recording electrodes in some patients, and who perform surgery for the treatment of epilepsy in specially selected patients.
• Neuropsychologists, who evaluate patients' neurological abilities (including memory and language functions), and design treatment plans for patients with disabilities in these areas (cognitive rehabilitation). Assessment can also be made of how seizures affect a patient's emotional state, and how emotions can in turn affect seizures.
• Nurses, who are experienced in the field of epilepsy, and who coordinate care of patients and provide education to patients and family.
• EEG technologists, who are fully registered by the American Board of Registration of EEG Technologists, and who assist in the technical aspects of long-term EEG monitoring.
• Social workers, who see to the special needs of patients with epilepsy and their families by identifying resources and facilitating follow-up in the home community.
• Dietitians, occupational therapists, physical therapists, and psychiatric nursing specialists are also available for consultation.

Epilepsy Monitoring Unit Patients

The EMU is designed with the comprehensive diagnostic and treatment needs of the patient in mind. There are many reasons you may consider referring your patient to the EMU. These include, but are not limited to:

• Diagnosis of episodic events, which may be difficult to evaluate in the office or clinic. Besides epileptic seizures, episodic spells may be due to a wide variety of other causes, including syncope, migraine headaches, anxiety attacks or other psychological reactions or metabolic conditions. The EMU is an ideal setting for sorting these issues out, because it permits the long-term observation and recording of electrophysiologic (EEG) and clinical activities.

• Classification of epileptic seizures. Some types of epileptic seizures may be difficult to classify through history, or even by direct clinical observation. As different seizures respond best to different medications, accurate classification can lead to more effective therapy.

• Localization of seizure focus for the purpose of epilepsy surgery. A patient who is refractory to medications may be a candidate for epilepsy surgery. This evaluation is carried out in the EMU, and involves recording a number of seizures, to attempt to localize their onset, and determining whether neurosurgery is a viable option. In selected patients, this procedure often greatly reduces or may even eliminate seizures.

• Assessing seizures before, during , and after medications adjustments. When treatment is changed, seizures may change, both in number and quality. The EMU can be used to assess these changes.

Related UI Hospitals and Clinics Facilities
The EMU works closely with many facilities at The University of Iowa Hospitals and Clinics, including:

• The Episodic Disorders (Epilepsy) Clinic, a subspecialty clinic in the Neurology, Department. The clinic sees over 1,000 patients a year with epilepsy and related conditions.
• The Pediatric Neurology Clinic, where children with epilepsy are evaluated and cared for.
• The EEG Laboratory, where routine waking and sleep EEG studies, special EEG studies, and evoked potential studies are performed.
• Neuroimaging, including the routine use of MRI and CT scans. The Neuroimaging Laboratory of the Department of Neurology also provides the capability of generating 3-dimensional image reconstructions from MRI and PET data, allowing detailed study of the brain's anatomy and function.
• Experimental Drug Studies, allowing patients with poor control of seizures access to the latest in epilepsy medications which are undgoing testing prior to their release. Many of the new medications show great promise in the treatment of seizures and the reduction of side effects.

Referral to the Epilepsy Monitoring Unit
Referrals to the EMU are welcomed and may be made by calling the Neurology Clinic at 319-356-2571. An initial clinic visit is preferred for all new referrals in order to review the patient's history and design the most efficient plan for your patient. Prior approval of admission may be necessary for patients belonging to Health Maintenance Organizations (HMOs) or covered under out-of-state Medicaid/Medicare. Our insurance specialists are willing to assist as needed. University Hospitals accepts all admissions, regardless of insurance status. Following your patient's evaluation a summary report, noting our findings and treatment recommendations, will be sent to your office.

Medial Staff of the Epilepsy Monitoring Unit

Mark A. Granner, MD, Director
Matthew A. Howard, III, MD, Epilepsy Neurosurgeon
John C. VanGilder, MD, Epilepsy Neurosurgeon
Thoru Yamada, MD, Director EEG