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 to stop their seizures may be possible.
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.
Patients with such concerns are admitted for 24-hour, continuous EEG video monitoring procedures and other tests that will allow our neurologists to make recommendations about treatment options. Patients generally spend seven days in the hospital to complete the entire testing process.
Preparing for your stay
- Visiting hours are 8 a.m. to 8 p.m.
- Telephones are provided in each room. Local calls can be made without cost. Long-distance calls must be made with a calling card. You will be given the phone number for your room when you arrive. Family and friends may call you directly.
- Televisions and free WiFi are available in each room.
- There are several reasonably priced hotels and apartments close to the hospital where family members can stay. You will need to make reservations in advance. Call the Regional Epilepsy Center at (206)744-3576 for more information.
- Harborview is a nonsmoking institution. You cannot smoke during your stay here. If you like, your doctor can order nicotine patches.
Here are our suggestions for what to bring:
- A list of all your medications and a one-day supply of medication. Our pharmacy will dispense any other medications you need during your stay.
- Casual and comfortable clothes such as jeans, sweatpants, button-down shirts or shirts with large necks, pajamas, robe, underwear, and slippers. Please be aware that the iodine solution we use to apply electrodes could permanently stain your clothing. There are no laundry facilities for patient use. Please bring enough changes of clothing for the length of your stay.
- Personal hygiene articles such as shampoo, deodorant, toothbrush, and toothpaste.
- Magazines, books, crossword puzzles, handicrafts, stationery, and games that can be used easily while in bed.
- Snack items such as fruit or soda. A small refrigerator is provided for patient use.
- Please leave anything of value at home. Harborview will not be responsible for theft or loss of personal property.
Here is what to expect during your stay with us:
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 be directed to the Epilepsy Inpatient Unit at 3 West Hospital.
Arrival at the Epilepsy Inpatient Unit
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.
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 and know how much of each you take and how often. Bring only a one-day supply of medication. Our pharmacy will dispense any other medications you need during your stay.
The EEG Video Monitoring Procedure
REC staff demonstrate electrode placement
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 an amplifier box, which is worn in a plastic pouch around your neck.
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.
You may be surprised that we want you to have seizures here in the hospital. This is necessary for our doctors to observe the site in the brain from which your seizures come. When the doctors get that information, they can decide on your diagnosis and the next step in your treatment.
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, especially from seizures. 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 whenever 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 at the nurses' station can also observe any seizure activity, even if you are not aware of it.
Allergies and Skin Irritation
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. Please immediately report any skin irritation from the gel used to attach the EEG electrodes. Please tell your nurse if you are feeling uncomfortable in any way.
Helping Us Help You
There are several things you can do to help us make your stay successful and comfortable:
Besides the monitoring process, your doctor may order other kinds of tests for you during your stay. The two most frequently ordered tests are magnetic resonance imaging (MRI) and a series of neuropsychological tests.
Magnetic Resonance Imaging (MRI)
An MRI is a special method that uses magnetism to give a picture of your brain at different levels. MRIs give more detailed images than CT scans and other types of x-rays. They also allow pictures to be taken from many angles without requiring you to move your head.
The MRI procedure may take as long as 15 to 30 minutes and is 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.
People with seizures often report problems with memory, concentration, and thinking. 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 five 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.
Meeting with the social worker
An epilepsy social worker may visit with you during your stay. The purpose of the visit is to get a better sense of issues other than seizures that affect your life. 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.
After your stay
Getting the Results of Your Tests
Your doctor will often give you some 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.