 |
|
 |
|
Phase II Monitoring "Advances in epilepsy surgery and electronic monitoring now make it possible to discover the origin of epileptic seizures and improve quality of life."
The Epilepsy Monitoring Unit (EMU) is part of the Comprehensive Epilepsy Center at The Wake Forest University Baptist Medical Center, which is internationally recognized for the medical management of epilepsy. With our staff of doctors, nurses, EEG technologists and psychologist, we provide the highest level of patient care and offer the widest array of epilepsy treatment programs available.
Over the last 25 years there have been many advances in the treatment of epilepsy, including various surgical methods. There are currently three types of operations performed to reduce or stop seizures: | | Lobectomy:This operation removes all or part of one of the lobes of the brain in which seizures begin. The most common type is a temporal lobectomy which removes seizure-generating tissue from the temporal lobe. Seizures with origins in other areas of the brain may also be treated with this type of surgery.
Corpus Callosotomy: This operation involves cutting the connections between the two brain hemispheres to prevent seizures beginning in one side from spreading to the other. This procedure is most often performed when a patient is having experiencing uncontrolled drop seizures or severe generalized tonic-clonic seizures.
Hemispherectomy: The procedure involves the removal of all or almost all of one hemisphere of the brain. It is only done in cases where there is a severely diseased, seizure-causing hemisphere. |
|
If data collected during your Phase I admission does not provide your physician with enough information to determine whether you would be a good surgical candidate, Phase II Monitoring may be needed. In order to give the doctors more information, you first will have surgery to place strip grids and depth electrodes directly into your brain. Strip grids consist of parallel rows of electrode contacts and are placed on the surface of your brain. Depth electrodes are inserted into the brain to reach deep recording sites. Both provide more accurate information as to the location of epileptic focus.
After a brief period in the recovery room, you will return to the Epilepsy Monitoring Unit. After approximately 24 hours of recovery, the electrodes are connected to the monitoring equipment. In this manner, your brain waves will be recorded and correlated with the simultaneous video and audio recording. In order to provoke seizures, we may reduce or discontinue your current medications. (Do not however, discontinue medications unless directed to do so.)
| |
Epilepsy Surgery Program
|
|
Scheduling Your Stay
The average Phase II EMU stay is seven to ten days; however, some patients need as few as three days or as many as fourteen. This admission must be scheduled around the availability of the EMU patient rooms, the surgeon and the operating rooms. We ask that you please be understanding about the options presented to you, as there is much to coordinate.
| |
What To Bring With You
While you are here, you will be required to remain in bed or in the dayroom; therefore, you should bring appropriate recreational items to occupy your time such as books, knitting, crossword puzzles, etc. As you will remember, the dayroom has a TV, VCR, computer games and arts and crafts. Electrical items such as radios and hairdryers, are not allowed without special permission from our engineering department as they may interfere with the EEG recording.
Bring plenty of clothing for your stay -- enough to last a week to ten days. Because the sensors on your body need to be accessible to the EMU staff, you should wear clothing that buttons up the front. To assist in the video monitoring process, wear colored, rather than white, clothes to provide contrast against the white sheets. Family members and friends can take laundry home or use one of the nearby laundry services. |
|
What Your Schedule May Include
Upon arrival, you will be given a standard nursing admission assessment similar to Phase I. Some patients may have Wada tests performed -- an invasive procedure to determine dominant speech and memory areas in the brain.
Once the preliminaries are finished, you will have surgery to place electrodes into your brain to receive clearer, more accurate information regarding your seizures. You will spend the next day or two recuperating. Depending on the severity of your seizures, it may be necessary to restrain you to ensure your safety and protect the implanted electrodes from possible damage. When your recuperation is complete, the electrodes will be connected to the EEG monitoring equipment to record your brainwave activity. | |
After connecting to the EEG equipment, we will wait for your seizures to occur. Each seizure will be analyzed and decisions regarding your care will be made. You will be kept informed as this dynamic process develops. Once enough information has been gathered, a conference will be held with your epilepsy team. At this point you may stay and have the surgery or you may have the electrodes removed and go home without the surgery.
If you do undergo surgery you should expect a recovery period anywhere from three to five days. We will make all efforts to have your post surgical recovery in the Epilepsy Monitoring Unit. After sleeping off the anesthesia for one day, you may experience bruising, headaches, nausea and puffiness to the face for the next several days.
|
|
Monitoring Restrictions
Many of the restrictions are the same that you experienced during your Phase I admission. In addition to these, you may experience more limitations for protection of the indwelling electrodes. You may be required to remain in your bed, or in some cases, soft restraints may be applied. You will be included in these decisions as we attempt to monitor your safety.
| |
* For the duration of your stay, you must remain within the range of our monitoring equipment. Your movement is limited to your room and the dayroom; you can not be monitored in other areas.
* While being monitored, you will be unable to shower. This restriction is necessary for your safety. You may, however, take sponge baths.
* No smoking is allowed in the EMU.
* Visiting hours are 10 AM - 8 PM. If you have children under 14 who wish to visit, please discuss it with the nursing staff.
|
|
Bring A Friend Or Family Member
From your previous visit you will recall that it is important you have a friend or family member who has witnessed your seizures to stay with you during your visit. As someone will need to remain with you 24 hours a day from the time you arrive until your release, it is advisable that you enlist the aid of more than one person.
| |
Your family members or friends again play a vital role in gathering information on your seizures. They assist the nurses and doctors in recognizing your seizures, testing your responses during seizures, and making your stay more pleasant.
|
back to top |
|
|
|
|