Neurology

Strong Epilepsy Center

Tests - Long Term Monitoring (LTM)

The best way for our team to analyze an individual's particular kind of seizure is to study a seizure while it is happening. Therefore, your doctor has asked that you come into one of our specially equipped rooms in the hospital to record some of your seizures on tape. We will simultaneously record your EEG and your behavior (video and audio).

You will stay in the hospital for one to two weeks until a sufficient number of seizures has been recorded. Most patients stay between 4 and 10 days.

We want you to have seizures during your Long Term Monitoring. This seems unusual to many patients who have spent their lives trying to avoid seizures. Your doctor will probably lower the dose of your medication to bring on seizures. Sometimes, patients experience "bigger" seizures than they have had before.

Your hospital room is set up to be as safe as possible. Your bed will have padded side rails and the side rails should remain up while you are in bed. If you are expected to have very frequent seizures, you will have an intravenous line. If you fall down during your seizures, someone should be with you when you are out of bed. When you have a seizure, a nurse should be alerted and he or she will come into your room to ensure your safety and to test your level of awareness.

Standard EEG electrodes will be applied to your scalp. You will wear a stocking cap and the EEG wires will come out of the cap like a ponytail. The EEG wires will be plugged into an encoder (a small, black, metal box) which is in a harness that fits around your chest and over your shoulder. It weighs about one pound.

In your hospital room, there may be a special rack which has VCR's, a camera, a microphone, and a video monitor. The encoder is connected to the rack by either a cable or a radio transmitter. You will be able to move around the room, but you cannot wander too far from the rack because you must stay in view of the camera. The bathroom is out of the direct view of the camera.

The recording equipment will be on continuously, all day and all night. The camera takes pictures of everything in its view. The microphone will record all sounds. In order to give you privacy, there is no equipment in the bathroom.

A neurophysiology technologist will come into your room regularly to check on you and the equipment. Our staff will become familiar to you throughout your stay and we will try to make you as comfortable as possible.

Prepare For Your Admission

Please wash your hair before coming to the hospital. Do not use conditioner, hair spray, or other hair products. Standard EEG electrodes will be attached for your entire stay so your hair and scalp should be clean when you start.
Bring comfortable clothes for daytime. Please wear shirts or tops that zip or button up the front. Pulling clothes over your head will interfere with the EEG wires. Sweat suits with tops that zip up the front are ideal. Our camera is black and white so darker clothing photographs better. Please do not wear white clothes.
For sleeping, please bring pajamas with tops and bottoms. They are suggested for both men and women. Nightgowns are not appropriate, especially those of light weight material.
Please bring cards, board games, handcrafts, books or other things to keep yourself occupied. It is important to keep active. It is our experience that if patients just lie in bed, they have fewer seizures. Please plan enough activities to keep you busy, in a small space, for more than a week. Most patients are happier when they have lots to do. Frequent visits from friends and family are encouraged.
We request that, if possible, a family member or friend stay with you at all times, while you are in the hospital. This observer must press the "event" button to mark a seizure on the record and must also press the "nurse call" button. Pediatric patients should have a responsible person with them twenty-four hours a day. Most of our patients work out a schedule of shifts for family and friends. We provide one cot and bedding in your room for the observer. Convenient over- night lodging is available for others at Ronald McDonald House, Goler House and other places. Our Inpatient Coordinator can help you with this. We have a refrigerator and a microwave to help with meals for family and friends.
Please note that Strong Memorial Hospital is a smoke-free environment. No one, including you, will be allowed to smoke in your room. If you are a smoker, this is an opportune time to quit!

After the Long Term Monitoring is over, your scalp may be tender, but you will want to get the glue from the electrodes out of your hair and scalp. Wash your hair carefully. Children will need a parent's gentle help with this task.

The records made by the audio-visual and EEG equipment will be carefully reviewed by a neurophysiologist. Then they are presented to the Strong Epilepsy Center (SEC) team conference. Three to four weeks after your discharge, your SEC doctor will discuss with you a detailed review of the findings and a treatment plan.