With a recently expanded 10-bed Epilepsy Monitoring Unit (EMU), UCSF Health’s Epilepsy Center is accelerating diagnosis and treatment planning for patients seeking care from Northern California and beyond. 

The EMU, located at UCSF’s Parnassus Heights campus in San Francisco, provides elective, inpatient evaluation for patients experiencing drug-resistant seizures or other spells that require characterization by electroencephalography (EEG). Current evidence-based guidelines emphasize that after patients have tried at least two medications and still have seizures, they should be evaluated further to find out whether other options like surgery could be more effective for their particular epilepsy.

Over multiple days, EMU clinicians record patients’ scalp or intracranial EEG with simultaneous video in order to characterize seizures and locate their source in the brain. The unit provides state-of-the-art EEG capability for 24/7 monitoring of EEG signals and seizure detection. Two of the rooms are equipped with cutting-edge intracranial monitoring systems for patients who require surgery for drug-resistant seizures. 

With the newest technology to collect and manage data, epilepsy specialists can determine how best to treat each individual patient, hopefully reducing seizure episodes or curing the disease altogether. Neurosurgeons, in consultation with UCSF’s Multidisciplinary Epilepsy Surgery Team, can identify the best surgical options for each patient, accelerating diagnostic workup and ensuring that options are personalized for every individual.  

“We’ve come so far in how we can treat epilepsy, both in terms of new medications and surgical options, but it’s important to escalate our use of diagnostic tools as much as possible,” says Vikram Rao, MD, PhD, director of UCSF’s Epilepsy Center. “By doubling the number of patients we’re monitoring at one time, we can determine the best options and get more patients the therapy they need more quickly. For patients suffering from this disease, the treatment can’t come fast enough.”

The UCSF EMU has been well received, growing by more than 50 percent since 2014 to support internal and Bay Area wide referrals for patients seeking specialists in epilepsy care. Its referrals are approximately 56% from communities outside the Bay Area, with partnerships to support neurologists throughout California and the country.

In the process of expanding the EMU to its 10-bed capacity, UCSF’s Epilepsy Neurodiagnostic Services has received three accreditations (EEG, Epilepsy Monitoring, and Critical Care LTM EEG Monitoring) awarded by the American Board of Registered EEG Technologists, becoming the first neurodiagnostic program in the Bay Area to achieve accreditation in all three disciplines. The program also has integrated ongoing education and opportunities toward credentialing and registration for its Neurodiagnostic (EEG) technologist staff members. Through this effort, more than 80 percent of UCSF’s EEG technologists are now credentialed in a registry that recognizes their higher skillset and expertise to support complex cases. 

Unit part of larger Epilepsy Center redesign

The expanded EMU is part of a major revamping of UCSF’s Epilepsy Center, designed to enhance care and treatment for patients in several areas. The many improvements include the following:

•   Enhanced EEG monitoring station for 24/7 monitoring of EEG signals and seizure detection 
•   Ability to monitor Video-EEG 24/7 in up to 26 patients hospital-wide 
•   Fully upgraded top-of-the-line software platform for collecting, monitoring and managing data
•   Integrated quantitative EEG platforms for advanced signal analysis and trending capabilities, including the newest technology for pinpointing the seizure source in the brain 

“What is particularly exciting is our increased ability to achieve a definitive diagnosis and to personalize treatment for each patient,” says Rao. “Treating epilepsy has long been a challenge for physicians, but utilizing the latest technology to pinpoint the source of seizures in the brain has allowed us to make huge advances in managing and, in many cases, curing this disease.”

For more information, contact the UCSF Epilepsy Center at (415) 353-2437