Comprehensive Epilepsy Center
Phase II Monitoring
For many epileptic patients, seizures can be controlled with medication. For other patients who can not control seizures with medications, surgery offers hope. In epilepsy surgery part of the brain causing the seizures can be removed, controlling and eliminating future seizures. As a Level IV Epilepsy Center, our team of doctors, nurses, EEG technologists and psychologist provide the highest level of patient care and offer the widest array of epilepsy treatment programs available.
When is Phase II Monitoring Necessary?
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 (EMU). 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 discontinue your medications unless directed to do so.)
The average Phase II EMU stay is from seven to ten days; however, some patients need as few as three days, or as many as 14. 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. The dayroom has a television, a DVD player, and arts and crafts. You may bring handheld video game systems and laptops. Wi-Fi is available. Outside electronics such as hair dryers will need to be checked by our engineering department before use in the unit.
Bring plenty of clothing for your stay – enough to last 10 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, clothes to provide contrast against the white bed sheets. Family members and friends can take laundry home or use one of the nearby laundry services.
Bring a Friend or Family Member
From your previous stay, 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.
Phase II Monitoring Schedule
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. 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 EMU. After sleeping off the anesthesia, you may experience bruising, headaches, nausea, and puffiness to the face for the next several days.
Many of the guidelines 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 cannot be monitored in other areas.
- While being monitored, you will be unable to shower. This restriction is necessary for your safety. However, you may take sponge baths.
- No smoking is allowed in the EMU.
- Visiting hours are from 10 am – 8 pm. If you have children under 14 who wish to visit, please discuss it with the nursing staff.