When a child experiences a brain-related issue, such as seizures, stroke or nerve and muscle issues, it can be frightening. The epilepsy monitoring unit (EMU) at Norton Children’s Hospital is a special unit with eight beds, where kids with epilepsy are closely watched with continuous monitoring. This place helps children who have epilepsy, unexplained seizures or other brain-related episodes that doctors are trying to diagnose. At Norton Children’s Hospital, we have a team of pediatric neurologists, epileptologists, neurosurgeons, nurses and medical staff working day and night to figure out what is causing the brain issues, where they are happening and how serious they are.

Norton Children’s Hospital offers outstanding testing, treatment and care for children with brain conditions through pediatric neurology services provided by Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine. 

Our pediatric neurologists treat your child’s health issues related to brain, spinal cord and all muscles, nerves and the blood vessels connected to them. Our team is dedicated to caring for children with very complex brain and nervous system developmental conditions. We ensure that your family is part of the process and has answers and support along the way.

Why Should My Child Visit an EMU?

If a child experiences their first seizure or they are already known to have epilepsy, they may be referred to an EMU. The close monitoring available in an EMU allows the health care team to record and evaluate brain activity to create a treatment plan that’s just right for your child. Tests done in the EMU can help the doctor identify what kind of brain condition your child may have and the exact type of seizure they are having. If your child might need surgery for epilepsy, a brain test called an electroencephalogram (EEG) can show the doctors the best kind of surgery to help.

What Happens in an EMU?

Once your child is comfortable and all checked in, we start the monitoring. First, we put tiny metal discs, called electrodes, on the child’s head. The discs are connected by wires to equipment which records and monitors brain waves through an EEG. Electrode placement is not painful, but we ask that the patient stay still as much as possible while the electrodes are attached. 

The patient is monitored by the constant EEG as well as a video camera. Watching the brain’s activity continuously for several days with the EEG gives our health care team a clearer understanding of the brain’s action, what the patient’s seizures look like and how the brain works before and after a seizure. 

Video and audio recording allow the EEG technologist to match up the brain wave patterns with what the patient is doing physically. 

If your child is taking medication for seizures or epilepsy, the doctors might lower the dose while the child is in the EMU. This is to see if a seizure might happen when it’s safe, in a hospital setting, with a medical team there to care for the child during and after the seizure.

The EMU rooms are comfortable, and your child can get up and walk around, as well as bring items from home such as a tablet, toys or games. As a parent or caregiver, you stay with the child during their time in the EMU. 

Each day, the EEG is reviewed by your child’s team of medical professionals, including neurologists and EEG technologists. We talk with the parent or caregiver daily, share what we’ve found out from the tests, answer any questions, and explain what we’ll do next or any other treatments we might consider.

What Happens When My Child Leaves the Epilepsy Monitoring Unit?

How long your child stays in the EMU depends on many factors, including the results of EEG monitoring, the type of seizure the child has and other specifics related to the child’s condition. If medication has been reduced or stopped, the patient may need to remain in the hospital until they are back on the medicine as prescribed. Your child won’t be sent home until medication is at a safe level. 

Your care team will go over all the results of testing, advise you whether further testing should be done, help you understand treatment options or care plans, share general information about the program, and answer any questions you or your child may have. 

Reviewed by Cemal Karakas, M.D., pediatric epileptologist with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine.

Why Norton Children’s Neuroscience Institute?

• The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.
• We are the first in Kentucky and among the first in the nation to use neurostimulation in a pediatric patient.
• Regional neurology care is available for children across Kentucky and Southern Indiana. We travel to clinics in Bowling Green, Campbellsville, Corbin, Elizabethtown, Frankfort, Owensboro and Paducah, Kentucky; and Evansville, Indiana. We also perform a number of telemedicine visits each week.
• The specialists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, use state-of-the-art technology to treat epilepsy, uncontrollable seizures and deep brain tumors in children who, in the past, would not be candidates for surgery, including:
  • Visualase: Technology that allows neurosurgeons to perform MRI-guided laser ablation surgery. Fewer than two dozen pediatric hospitals in the U.S. offer this technology.
  • Surgical Theater: Virtual reality technology that creates an immersive 3D view of a patient’s brain, allowing neurosurgeons, the patient and family to see inside the skull and brain to get a greater understanding of the condition and impact of potential procedures. Norton Children’s Hospital is the first hospital in the region to use this technology.
• We offer dedicated multidisciplinary clinics for brain tumors, traumatic brain injuries, spina bifida, craniofacial injuries and disorders, epilepsy, muscular dystrophy, spasticity, headache/migraine, autism and neurocutaneous disorders.
• Our multidisciplinary craniofacial program was the first established in the Midwest.
• We offer a neurogenetics clinic to evaluate and treat children with neurogenetic syndromes.
• We have a neuropsychology program that specializes in the evaluation of children and teens with a variety of neurological, neurodevelopmental and medical conditions, including brain tumors and epilepsy.
• Outpatient neurology facilities in downtown Louisville are equipped with in-office electroencephalography (EEG) capabilities and laboratory services in the same building, creating a streamlined, family-centered environment.
• We offer the region’s first clinic to treat children with immune-mediated neurological disorders.