Epilepsy is a medical condition that makes people susceptible to recurrent seizures. These seizures — which can present with many different symptoms — result from brief, but strong, surges of electrical activity in the brain.
Epilepsy and seizures affect 3 million Americans, with 180,000 new cases of epilepsy diagnosed each year. One in 10 people has a seizure by the time he or she is 85 years old.
Seizures can last from a few seconds to a few minutes. They can have many symptoms, from convulsions and loss of consciousness to some that are not always recognized as seizures by the person experiencing them or by health care professionals: blank staring, lip smacking, or jerking movements of arms and legs. These abnormal brain functions can be present in an infant at birth, or they can develop later in life due to a traumatic brain injury or degenerative brain disease.
While a standard, one-hour EEG (electroencephalogram) is a useful test in epilepsy diagnosis, this short measurement and recording of the brain's electrical activity has many limitations.
More accurate and efficient is a prolonged three- to five-day study in an epilepsy monitoring unit (EMU), where the patient can be examined while performing normal daily activities. In its controlled environment, longer-term EMU monitoring can:
• Confirm the diagnosis of epilepsy.
• Localize epileptic foci for potential epilepsy surgery.
• Identify seizure type for most effective medication choice.
• Determine a non-epileptic ("pseudo-seizure") cause of events.
Via continuous video monitoring (which patients are made aware of), the staff watches EMU patients around the clock. They watch for even the most subtle seizure signs such as a sudden stare or slight finger twitch. EMUs typically maintain a strict fall precautions protocol and are furnished with low therapeutic beds and seizure padded floors for safety.
Specialists look for EEG abnormalities, study sleep patterns (some non-epileptic spells are sleep disorder-based) and evidence that may indicate surgical intervention to control epilepsy.
Some facilities also have mobile monitoring devices that can be moved to the intensive care unit or other areas as needed. More than 20 percent of unresponsive neurological ICU patients may demonstrate epileptic activity on an EEG that, if untreated, can lead to irreversible brain damage.
It's important to ask your physician questions if anti-epileptic drugs or other methods aren't working for you. Visiting an EMU can help improve your quality of life and management of a disorder.
Daniel Mattson, MD, is the director of epilepsy services for the SSM Neurosciences Institute and oversees the Epilepsy Monitoring Unit at DePaul Health Center. He is a board-certified in neurology and clinical neurophysiology, and he is fellowship-trained in epilepsy treatment. His office is located at 12255 DePaul Drive, Suite 200, in the North Medical Office Building. He can be reached at 314-355-3355.
