After an EEG, the next step to prepare your child for surgery is to have an epilepsy monitoring unit (EMU) session in the hospital. Your child’s team will give you a date to go to the hospital, and your child will be admitted as an inpatient for a few nights.
The EMU session will last three to five days, depending on how frequently your child has seizures.
Why does my child need a session in the EMU?
The aim of an EMU session is to capture the electrical activity in your child’s brain during a seizure and document what your child does during the seizure.
During the session, the electrical activity in your child’s brain will be measured using a special EEG machine that is connected to a video camera and a microphone. This allows your child’s health-care providers to match the wavy lines on the EEG with your child’s activity to try and find out exactly where seizures begin in their brain.
The EMU is a controlled and safe environment to record your child’s typical seizures. The doctors and nurses are there to help control your child’s seizures with fast-acting anti-seizure medication.
Does the test have any risks or side effects?
Your child will not experience risks or side effects from the EMU session. However, there is a risk that your child may have several seizures during their stay.
Please be assured that the EMU is a safe environment where doctors, nurses and technologists can help your child quickly when needed.
How do I prepare my child for an EMU session?
- Explain what will happen during the EMU session in words your child understands.
- Pack enough changes of clothes for three to five days and some enjoyable activities (such as colouring books, movies, video games or music) to keep your child entertained while they are in the hospital.
- Make sure your child’s hair is freshly washed. Check for any signs of head lice and tell the nurse at the hospital if you see anything.
- To help the EEG electrodes stay in place on your child’s scalp, do not use conditioner or styling products in your child's hair after you wash it.
- You may get a call from the EMU team about weaning your child's anti-seizure medications before admission. This is to increase the chance of capturing seizures in the EMU. Make sure to follow the advice of the health-care team.
What happens when my child arrives for the EMU session?
- Once your child is admitted to the EMU, an EEG technologist will measure and mark your child’s scalp with a wax pencil so they know where to place the electrodes.
- The technologist will clean the marked areas on your child's head with a gel and use special skin glue called collodion to attach the electrodes to your child's scalp. The glue keeps the electrodes on your child’s scalp for several days while your child is awake and asleep.
- The technologist will then connect the electrodes to the video EEG machine in the EMU room.
What happens during the EMU session?
The EEG electrodes on your child’s scalp will be attached to a video EEG machine, which will record the EEG brain wave patterns, video and sound activity.
Just as in a routine EEG, the technologist may ask your child to do different activities, such as:
- breathing deeply for three minutes
- opening and closing their eyes
- watching flashing bright lights for a few minutes
- having the test while sleepy or asleep
These activities stimulate different types of brain activity, which in turn create different types of EEG patterns. They also make a seizure more likely, which helps your child’s team identify specific seizure causes.
The video EEG should generally not hurt, but your child may feel some pain from the EEG electrodes pulling on their hair or may experience skin irritation from the special glue.
The EMU medical team may ask you to wean your child's anti-seizure medications so that they can capture seizures during the stay. Sometimes, they may also ask that your child gets less sleep before their stay for this same reason.
Depending on the clinical and EEG findings from previous tests, your child's health-care team may plan more tests during the EMU stay, including brain scans (MRI, MEG, PET scans) and genetic testing.
May I stay with my child during the EMU session?
The EMU is a care-by-parent unit, which means you can stay with your child during the EMU session. Your child will also be closely monitored by nurses and doctors.
What should I expect after an EMU stay?
Once your child’s team has captured your child’s typical seizure and checked the quality of the recordings, the electrodes will be removed from your child’s scalp. Your child will then be released from the EMU.
Your child’s hair may be a little sticky from the special glue. You can easily wash it away with shampoo and water.
When will I get the test results?
Your child's health-care provider will receive the EMU test results and discuss them with you and your child at a follow-up appointment within four to six weeks.
If your child's health-care provider has told you that your child needs a sedative (medicine to keep them calm) to put on the EEG wires, a nurse from the Neurophysiology Department will contact you with instructions on when your child needs to stop eating and drinking before being admitted to the EMU.
If the EMU is booked without arranging a sedative, but you think your child will need it, please contact the Neurophysiology Department one week before the appointment at 416-813-6297.
