The expanded service reduces the time patients wait for an evaluation that takes about three days of inpatient care at Cayuga Medical Center, says Cynthia Correll, MD, the monitoring unit’s director. She has certifications in neurology, epilepsy and neurophysiology from the American Board of Psychiatry and Neurology.
Epilepsy is among the most common neurological diseases and affects about 1% of the population. It is a lifelong condition in most patients and recurrent seizures affect physical, cognitive, psychological, and social functioning.
“Despite its prevalence, epilepsy is often misdiagnosed. About a third of patients evaluated at an EMU have a functional neurological disease and need a very different treatment than for epilepsy,” Dr. Correll says.
Making the correct diagnosis so patients get the correct treatment is a big part of the work at Cayuga’s Epilepsy Monitoring Unit. About 70 percent of patients with epilepsy can manage their seizures with anti-epileptic medicines. The diagnostic work is done at CMC’s Epilepsy Monitoring Unit with a patient’s seizure medication supervised by Dr. Correll or other neurologists at Cayuga Neurologic Services team.
Medications fail to control seizures for about 30% of epilepsy patients. Surgery or a strict diet are potentially curative for those cases. When epilepsy patients need complex neurosurgery, the Cayuga EMU often refers them to the Epilepsy Center at the University of Rochester Medical Center.
Epilepsy surgery options include removing the portion of the brain that is causing the seizures. Other surgical techniques implant a device to control a patient’s seizures with electrical pulses that the patient does not feel. Following the implant surgery, patients can find long-term management of their devices from the Cayuga Neurologic Services team.
Cayuga Medical Center’s EMU can accommodate up to three adult patients in private suites. The evaluation can last a week as medications are reduced to induce a seizure. Patients are fitted with electrodes to monitor their brain waves while a video records their movements throughout the assessment. If brain activity signals a seizure, the two recordings can be compared and evaluated. Nurses trained in epilepsy care make regular room checks and use a desk station monitor to watch over patients and respond to an alarm that is activated when clinical seizures or other events occur. Throughout the monitoring evaluation that could last up to five days, an on-site hospitalist is also available if an EMU patient needs medical care.
“The goal for a patient having a seizure in the EMU is to get information to guide the patient’s long-term treatment,” Dr. Correll says. Since the opening of CMC’s EMU in July 2023, the EMU staff has helped numerous patients to obtain a correct diagnosis, update their treatment plan, determine epilepsy surgery candidacy and provided urgent inpatient medication adjustments.
The EMU staff encourages patients to have a family member or friend stay with them during the evaluation, and a pull-out bed is available for overnight stays. Friends and relatives often recognize early signals of when a patient may have a seizure, Dr. Correll says.
Because of the potential for a 5-day hospital stay, the patients are urged to bring books, hobby crafts to work on, a tablet PC and snacks to supplement what the hospital also provides. Patients can have visitors during visiting hours who may bring food or order food delivery.
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For more information on the Epilepsy Monitoring Unit at Cayuga Medical Center and Cayuga Neurologic Services, call (607) 273-6757.
