ADVERTORIAL
Epilepsy Care Redefined : A New Era at Baptist Health Louisville
AMY PORTER , RN , MSN , SCRN , NEUROSCIENCE COORDINATOR & EPILEPSY RN CLINICAL LEAD
Approximately 2 % of the population of Kentucky are living with epilepsy and over 27,310 persons in metro Louisville have a diagnosis of epilepsy . For the patient , there is a stepwise progression ; a ) from a first single unprovoked seizure ( FSUS ), b ) initiation of single or multiple-medication therapy to control seizures and , c ) for one-third of these patients , evaluation for surgical intervention when medications alone do not control seizures . The best method for treatment depends on a definitive classification of seizure type . For many patients with seizures that are refractory to medications , a subsequent step may be a comprehensive evaluation in an Epilepsy Monitoring Unit ( EMU ).
Baptist Health Louisville has announced plans to open a 4-bed medical EMU in February . The EMU will be located on 5-Park , the acute neuroscience unit . The typical patient will have a current diagnosis of epilepsy . The objective of the EMU admission is to closely observe the patient via trained clinical staff , EEG tracings and synchronized video , during the onset , inter-ictal and post-ictal phase of the seizure . To ensure that seizures can be observed in the safe , controlled environment of the EMU , seizures may be induced through mild stimulation and reduction of anti-epileptic drugs ( AED ).
The overall goal of the EMU admission is to classify and localize the seizures . Classification of seizure type will guide the epileptologist ’ s consideration and referral for neuromodulation such as vagal nerve stimulation ( VNS ) or responsive nerve stimulation ( RNS ). Additional treatment decisions , based on the EMU stay , may include adjustments to medications , referral for cognitive testing with a neuro-psychologist , referral for psychogenic non-epileptiform seizures ( PNES ) treatment with a neuropsychiatrist or referral for surgical intervention for their epilepsy .
To accomplish the technical aspects of the EMU process , electroencephalography ( EEG ) and video equipment has been installed in 4 existing rooms on the acute neuro-telemetry unit . In addition , the project team has installed redundant video and EEG trace monitoring stations on 5-Park and in the newly opened and American Board of Registered EEG Technician ( ABRET ) accredited outpatient neurodiagnostic lab . The EEG technicians can continuously video and EEG trace monitor ( V / TrM ) all patients . The V / TrM hub in the neurophysiology lab is being designed to provide monitoring for all continuous EEG patients in the Baptist Health Louisville region .
The EMU will serve patients with breakthrough seizures despite therapeutic levels of two or more AEDs , as well as those with unclear seizure event classification , including suspected PNES . Admissions to EMU will be on a planned , outpatient basis , allowing the patient to plan for their stay in advance of the visit , making all
32 LOUISVILLE MEDICINE ADVERTORIAL