Epilepsy Monitoring Units (EMU)
Johns Hopkins Neurology has two specialized epilepsy monitoring units: one for adults and another for children.
High Tech Evaluation for Individualized Epilepsy Treatment
Epilepsy, seizures and seizure-like disorders can be challenging to treat. Every person with seizures is different, and the best treatment may include medication, stimulation techniques, diets or surgical procedures.
Identifying the most appropriate treatment plan for you or your family member starts with a thorough evaluation and diagnosis. Equipped with computer-based monitoring equipment expressly designed for the evaluation of seizure disorders, the EMU team can gather data before a seizure starts, while one is occurring and during recovery.
This approach can provide answers about your seizures’ characteristics and help doctors identify the type(s) of seizures and other clues that can shape your treatment.
What to Expect When You Visit Our EMUs
Mackenzie Cervenka, M.D., director of the adult epilepsy monitoring unit (EMU), and Sarah Kelley, M.D., director of the pediatric EMU at Johns Hopkins, share details about the units and their purpose, why patients are referred, and what happens after discharge.
A Multidisciplinary Team for Epilepsy Diagnosis
The EMU brings together specially trained experts in technology and patient care specific to the patient with epilepsy.
Your EMU team may include Johns Hopkins neurologists, neurosurgeons, nurse specialists, EMU technologists, clinical technologists, epilepsy fellows, neurology residents, medical students, nursing students, psychologists, psychiatrists, case managers and social workers to cover all aspects of your life affected by seizures.
Additionally, the EMU has a primary nurse and EMU operations manager, who assists in planning and coordinating your care before your admission
Behind the scenes, EMU technologists and biomedical engineers supervise the functioning of the high tech monitoring equipment.
Your Stay at the EMU
You will likely start with an initial outpatient consultation with a neurologist at Johns Hopkins, or your own outpatient neurologist may refer you to the EMU. If you have an outpatient neurologist outside of the Johns Hopkins system, we may recommend that you see one of our neurologists before coming to the EMU.
The length of your stay in the EMU depends on what your tests reveal, the frequency of your seizures and other factors, but most people stay between 3 and 7 days. After you leave the EMU you may need to remain in the hospital for a day or two so the team can regulate or readjust your medications and ensure you are safe to return home.
If you are taking medications to control your seizures, you may be instructed to temporarily reduce or gradually stop your medication during hospitalization. This allows the EMU staff to record and analyze your seizures while they are happening. You will be safely under observation at all times in the EMU, so discuss any concerns with your doctor and nurse coordinator.
What to Bring
- A sleep mask, provided that it ties at the back of the head
- 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, since they will need to be inspected by Clinical Engineering when you arrive)
- All your medications. After a medical review of all your medicines, we will store them safely and dispense them to you or ask a family member or care provider to take them home. 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, crafts
- Favorite toys and blankets for children
Arriving at the EMU
On the day and time of your appointment, you will check in at The Johns Hopkins Hospital's main admitting office. The admission process may take two hours or more. Please take your prescribed morning medications on the day of admission unless instructed not to by your physician.
Once you have completed the registration process in the admitting office, you will be escorted to the unit. Each EMU patient has a private room and bathroom with a toilet, sink and wash basin. You will not be permitted to shower when wearing electrodes on your scalp because they must stay dry. After monitoring is completed and the electrodes are removed, you may shower. If someone is staying with you, they may use the shower throughout your hospital stay.
Tracking Your Seizures at the EMU
While you are in the EMU, you will be recorded on video and computerized electroencephalogram (EEG) monitoring equipment, which will be connected to your scalp 24 hours a day, recording your movements, speech and brain waves. We understand that this can feel invasive or bothersome to some people, but it is the best way to keep you safe and to capture information about your seizures so the EMU team can treat you more effectively. You will not be recorded on video in the bathroom.
You will have a button at your bedside that you can press to alert the staff if 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 occurring. Microphones in each room will ensure that the team can both hear you and record the seizure event.
Visitors and Family Members
While in the past we have encouraged family and visitors to spend as much time with the patient as they wish, we cannot do that at this time because of COVID-19. Please refer to the Johns Hopkins visitor guidelines for the most up-to-date information about visitation. The EMU nurse coordinator and EMU staff assistant can also assist you with any concerns regarding visitation.
Please note: For patients under age 18 or any patient with special needs, one adult family member is required to stay with the patient for the duration of their stay in the EMU. Please discuss these arrangements with the EMU nurse coordinator or EMU staff assistant when scheduling an admission.
Epilepsy Surgery Stories | Johns Hopkins Epilepsy Monitoring Unit
Two patients share their experiences at the Johns Hopkins Epilepsy Center. Halle had been struggling with frequent seizures for almost thirteen years, starting from the time she was just 3. Erica had success managing her seizures with medications for years, but decided to pursue surgery after several breakthrough seizures. Both underwent surgery here at Johns Hopkins.