Epilepsy Monitoring Units (EMU)
The Johns Hopkins Epilepsy Center has two specialized epilepsy monitoring units (EMUs): one for adults and another for children.
Please note, for patients under age 18 or any patient with special needs, a parent or care partner (not hospital staff) must stay with the patient at all times (24/7) throughout the admission.
The Role of an EMU in Epilepsy Treatment
Epilepsy, seizures and seizure-like disorders can be challenging to treat because each person’s symptoms and experience are different. Identifying the most appropriate treatments for each patient starts with a thorough evaluation and diagnosis. The EMU team uses computer-based monitoring equipment to evaluate seizure disorders and gather data before a seizure starts, while one is occurring and during recovery. This detailed approach can provide answers about the characteristics of your seizures and help doctors identify the type(s) of seizures you are having, along with other important information that can guide and personalize your treatment plan.
Schedule an EMU Admission
This information applies to both adult and pediatric EMUs at Johns Hopkins.
For Patients
To be evaluated in an EMU, patients need a referral from a neurologist. If you already see a neurologist, please have them send a referral to our team by following the instructions for referring physicians below.
If you do not have a neurologist, please call 410-955-9441 (adults) or 410-955-4259 (pediatrics) to schedule an evaluation with an epilepsy specialist. When you call, mention that you would like to be evaluated for EMU admission. If you already have a neurologist outside of Johns Hopkins, you can have them perform the evaluation and make a referral. However, our team may still request you to be seen at Johns Hopkins if we need additional information or tests before your EMU stay.
For Referring Physicians
- Neurologists: Please fax the referral to our EMU program coordinator at 410-367-3305. An attending physician will review your request. Our team will reach out to the patient to schedule the admission or have the patient schedule a neurology consultation if additional information or tests are needed before scheduling with an EMU.
- Non-neurologists: Please have the patient call 410-955-9441 (adults) or 410-955-4259 (pediatrics) to schedule an evaluation with an epilepsy specialist.
Your Stay at the EMU
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The EMU brings together experts with specialized training in patient care and technology to meet the unique needs of people with epilepsy.
Your EMU team may include neurologists, neurosurgeons, nurse specialists, EEG technologists, clinical technologists, epilepsy fellows, neurology residents, medical students, nursing students, psychologists, psychiatrists, dietitians, case managers and social workers. Together, the EMU team members work to evaluate your seizures and create a tailored treatment plan.
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The length of your stay in the EMU depends on what your tests reveal, the frequency of your seizures and other factors. The length of stay is determined during the admission. Most people stay in the EMU for three to seven days.
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If you are taking medications to control your seizures, you may be instructed to temporarily reduce or gradually stop them during your EMU stay. This allows the EMU staff to record and analyze your seizures while they are happening. During this time, you will be under continuous observation, and staff will respond right away if you need help.
If you have any questions or concerns, talk to your doctor and nurse coordinator so they can explain what to expect and adjust the plan based on your situation.
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- Your continuous positive airway pressure (CPAP) machine or other home medical equipment Please let the EMU staff know in advance if you need these items, as they will need to be inspected by Clinical Engineering Services when you arrive.
- All your medications and supplements. After a medical review of the medicines, we will store them safely on the unit or ask a family member/care partner to take them home. Medicines will then be dispensed from the hospital’s pharmacy except in rare circumstances where medication is not available. In this case, the home medication will be verified by the pharmacist, secured on the unit and administered by the nurse. All medications will be returned to you at the end of admission.
- Please do NOT bring medical marijuana or other cannabis products onto Johns Hopkins property as they are strictly prohibited.
- Loose-fitting clothing, including shirts and tops that button in the front. No pullovers or t-shirts.
- Personal care items
- Books, games and crafts
- Favorite toys and blankets for children
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Please take your prescribed morning medications on the day of admission unless instructed not to by your physician. On the day and time of your appointment, you will check in at The Johns Hopkins Hospital’s main admissions office (adult patients) or the patient service center in the pediatric emergency department (pediatric patients).
The admission process usually takes less than 30 minutes. However, if a bed is not immediately available, there may be a wait of an hour or more. Once you have completed the registration process in the admissions office, you will be given directions to the unit.
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Each patient at the EMU has a private room and bathroom with a toilet, sink and shower. Rooms are also equipped with:
- A pull-out sleep sofa
- Free Wi-Fi
- Interactive TV system, including games and educational videos
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You will not be allowed to shower during admission while the electrodes are on your scalp or if you have surgically implanted electrodes, because your head must stay dry. However, you can wash up from the neck down at the sink every day. Some patients find bringing baby wipes from home helpful.
After monitoring is completed and the electrodes are removed, you may shower.
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We encourage family and visitors to spend as much time with the patient as they wish. Please refer to the Johns Hopkins visitor guidelines for the most up-to-date information about visitation. Our team can also help you with any concerns regarding visitation.
Preparing for Your EMU Stay
Epilepsy Monitoring Unit (EMU) Patient Information | Johns Hopkins Adult and Pediatric EMUs
Preparing for your Epilepsy Monitoring Unit (EMU) Stay: Johns Hopkins Adult and Pediatric EMUs
Tracking Your Seizures in the EMU
Electrodes and Audio/Video Recording
While you are in the EMU, you will have electrodes attached to your head 24/7 to record brain activity. Electrodes are connected by wires to electroencephalogram (EEG) monitoring equipment, which records your brain waves. Your room has cameras and microphones so we can see what your seizures look like and hear any descriptions or sounds you make during a seizure event. This helps the care team evaluate each seizure accurately and safely. We understand that this can feel invasive or bothersome, but it is the best way to keep you safe and to capture information about your seizures.
Alert System
You will have a button at your bedside to alert the staff when you feel a seizure coming on, including any auras if you tend to experience these before your seizures. If you have a seizure, you or your visitors can press the button and verbally describe what is happening.
Distinguishing Functional Seizures from Epileptic Seizures
Functional seizures, also sometimes referred to as psychogenic nonepileptic spells (PNES), are a subtype of functional neurological symptom disorder (FND). People experience functional seizures in the form of attacks, episodes or spells. Functional seizures can look like epileptic seizures and can include altered consciousness as well as sensory or motor symptoms.
Differentiating functional seizures from epileptic seizures can be challenging and is best done through long-term video EEG monitoring, as provided in the Johns Hopkins EMUs. Functional seizures are diagnosed if the tests show the presence of specific seizure signs or symptoms without abnormal EEG recordings or other medical causes.
Patients interested in evaluation or re-evaluation for functional seizures should call the neurology department at 410-955-9441 to request an appointment. Diagnosis and treatment are offered as part of the Functional Neurological Disorder Program.
If the EMU stay confirms functional seizures, our neuropsychologist can meet with you to help determine what kind of treatment might help.
Epilepsy: Patient Resources
Learn about available support resources for people with epilepsy and their families and about the ongoing epilepsy research at Johns Hopkins.
