Monitoring at the West Haven VA/Yale University School of Medicine Epilepsy Center.

The Epilepsy Center of the West Haven VA Medical Center and Yale University School of Medicine was established in 1970. Nearly 2800 patients have been admitted and 130,000 h of EEG/video monitoring have been performed. Of the 300 annual admissions, over half are for diagnostic purposes and the majority of the remainder involve pre-surgical evaluation or post-surgical followup. Intensive monitoring at West Haven/Yale has been and continues to be based upon several fundamental concepts--continuous 24 h/day recording of EEG via cable telemetry, simultaneous video/audio recording of patient behavior, pen-written paper copy EEG for at least 24 h of the monitoring period, and around the clock capability for direct interaction with the patient to assess neurologic function. This maximal utilization has been possible because of a corps of specially trained nurses, who not only provide nursing care, but who can function as EEG technologists in their absence. Although pen-written EEG and multiplexed EEG recorded on video tape have been the monitoring mainstays at West Haven/Yale, ambulatory cassette and digitized computer recordings have recently been introduced. The resultant combined monitoring approach emphasizes the strengths of each technique and minimizes their weaknesses. The Epilepsy Center, its extensive patient population and a variety of talented personnel have formed a critical mass, the results of which have been numerous clinical investigations in the diagnosis and treatment of epilepsy.