Inpatient Services
Patients come to the Epilepsy Center for a variety of reasons. Most have epilepsy that has been hard to manage with drugs. These patients hope that a medication change may reduce their seizure frequency, or they hope that surgery may be possible to stop their seizures.
Some patients come because they have seizure-like symptoms. These patients want to know whether they have epilepsy, or if their symptoms are due to some other cause. Sometimes patients have non-epileptic seizures that are due to heart or blood vessel disease, or to emotional and stress factors.
The patient is admitted for a 24-hour, continuos EEG-video monitoring procedure and other tests to allow our neurologists to make recommendations about treatment options. Patients generally spend seven days in the hospital to complete this testing process.
Here is what to expect to happen during your stay with us:
Reporting to the Admitting Office
The EEG-Video Monitoring Procedure
Additional Testing During your Stay
Meeting with the Social Worker
Reporting to the Admitting Office
On the morning of your admission, you will first report to the admitting office. It is located on Ground West Lobby (main hospital entrance on 8th Ave). You will go through standard admission procedures and will get an ID band. You will then go to the Epilepsy Inpatient Unit on 3 West Hospital.
When you arrive at the nurses' station of the Epilepsy Inpatient Unit, a nurse will interview you and explain the testing process and your care plan. We want you to feel comfortable and fully informed, so please ask any questions you wish.
The EEG-Video Monitoring Procedure
You are going to be on continuous video monitoring during your admission, except when in the bathroom. The camera recording your seizure events is connected to a computer that records your brain waves. To obtain this important information, small metal electrodes filled with gel will be attached to your scalp and chest with glue and gauze. Wires from the electrodes are plugged into a transmitter, worn in a plastic pouch around your neck. Often, very fine, thin wires will be inserted below your cheek bones. These wires are called sphenoidal (sfee-noy-dal) electrodes. They record brain waves from the underside of your brain.
This technology allows us to observe and record your seizures and your responses to them. It tells us if your seizures are coming from a specific location in the brain. Because we need to observe several seizures, your doctor may lower or stop your anticonvulsant medication. By adjusting your medication, we hope to increase the number of seizures you have while on the monitor.
After making efforts to stop your seizures, you may be surprised that we want you to have seizures here in the hospital. This is necessary so our doctors can observe the site in the brain where your seizures come from. When they get that information, the doctors can decide on your diagnosis and the next step in your treatment.
We do everything possible to keep you comfortable. However, some patients have allergies to the materials we use. Please let us know immediately if you are allergic to iodine soap, local anesthetics (the kind used during dental work), latex (rubber), metal, or adhesive tape. It is important to report any skin irritation from the gel of the EEG electrodes immediately.
Occasionally, swelling or slight bleeding occurs where the sphenoidal electrodes have been applied. You may also have some discomfort with chewing or talking, but that rarely lasts more than a day. Please tell your nurse if you are feeling uncomfortable in any way.
There are several things you can do to help us make your stay successful and comfortable:
Medications
Please come prepared to discuss your medical history with the nurse during admission. It is important that you bring a list of all your medications, how much of each you take and how often. Bring only a one-day supply of medication when you arrive. Our pharmacy will dispense any other medications you need during your stay.
The hospital is a safe place to have seizures because our nurses are specially trained and are here 24 hours a day to help you. They will do everything they can to make your environment safe and to protect you from injury. We make two specific safety precautions throughout your stay: (1) the guard rails of your bed are kept up at all times; (2) a nurse must stand by anytime you are out of bed.
Our nurses will ask you to report all seizures, auras, or seizure warnings that you have. They will show you how to use the seizure alarm located next to your bed. Any time you feel a seizure coming on, you will press the alarm to alert the nurses. They will be on hand to help whenever you need assistance. Because you will be monitored 24 hours a day, nurses can also observe any seizure activity that you may not be aware at the nurses' station.
Additional Testing During your Stay
Besides the monitoring process, your doctor may order other kinds of tests for you during your stay. The two most frequently ordered are a series of neuropsychological tests and magnetic resonance imaging (MRI).
Neuropsychological Testing
People with seizures often report problems with memory, concentration, and motor abilities (bodily movements). We give neuropsychological tests to measure such problems. The tests also provide information on areas in which you have strengths.
You will be asked to solve puzzles, answer questions, work with objects, and remember words and sounds. Please don't be anxious about the tests -- you cannot fail them! They usually take seven to eight hours for an adult to complete. The tests are shorter for children. Patients are tested one at a time. The tests may be challenging but they can also be fun.
MRI
An MRI is a special x-ray that gives a three-dimensional (3-D) picture of your brain. MRIs often provide better images than other types of x-rays. They also allow pictures to be taken from many angles without moving your head.
The MRI procedure is long, often noisy but painless. You will need to lie flat and still as you move through a narrow cylinder. If you have a fear of being in closed-in places, please tell our staff before the test.
Meeting with the Social Worker
The epilepsy social worker will visit with you during your stay. The purpose of the visit is to get a better sense of issues affecting your life, in addition to seizures. You will have the opportunity to discuss questions or concerns and to obtain referrals for other types of services, if needed. The social worker can be a good resource for you and your family.
Now that you have a sense of what's going to be happening while you're in the hospital, you are probably wondering what to bring with you. Here are our suggestions:
Please leave anything of value at home. Harborview will not be responsible for theft or loss of personal property.
Your doctor will give you preliminary results before you leave the hospital, but a complete report will not be available for several weeks. Each patient's test results are carefully reviewed in a group conference of doctors and specialists. We want your evaluation to be as thorough as possible so that we can decide on the best course of treatment.
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Regional Epilepsy Center
Seattle, Washington,
USA
(206)744-3576 or
(1-800-374-3627)
