Seizure detection and mobile health devices in epilepsy: Update and future developments

Ryvlin, Philippe; Beniczky, Sándor

doi:10.1111/epi.14088

Cited by 15 publications

(8 citation statements)

References 12 publications

(21 reference statements)

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“…The care of our chronic patients could benefit even more if video systems are installed and more complete access to electronic records and online scales is granted. Patients with epilepsy may have a wider experience with e-tools for seizure counting and with seizure detection devices, so they may be friendlier to technology than other neurology patients [14]. It is perceived that some patients would agree to be controlled in this way in the future [15].…”

Section: Discussionmentioning

confidence: 99%

Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic

Conde‐Blanco

Centeno

Tió

et al. 2020

Epilepsy & Behavior

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Teleneurology in Spain had not been implemented so far in clinical practice, except in urgent patients with stroke. Telemedicine was hardly used in epilepsy, and patients and neurologists usually preferred onsite visits. Our goal was to study impressions of adult and pediatric epileptologists about the use of telemedicine after emergent implementation during the new coronavirus 2019 (COVID-19) pandemic. Methods: An online survey was sent to the members of the Spanish Epilepsy Society and the members of the Epilepsy Study Group of the Catalan Neurological Society, inquiring about different aspects of telemedicine in epilepsy during the pandemic lockdown. Results: A total of 66 neurologists responded, mostly adult neurologists (80.3%), the majority with a monographic epilepsy clinic (4 out of 5). Of all respondents, 59.1% reported to attend more than 20 patients with epilepsy (PWE) a week. During the pandemic, respondents handled their epilepsy clinics mainly with telephone calls (88%); only 4.5% used videoconference. Changes in antiseizure medications were performed less frequently than during onsite visits by 66.6% of the epileptologists. Scales were not administered during these visits, and certain types of information such as sudden expected unrelated death in epilepsy (SUDEP) were felt to be more appropriate to discuss in person. More than 4 out of 5 of the neurologists (84.8%) stated that they would be open to perform some telematic visits in the future. Conclusions: In Spain, emergent implantation of teleneurology has shown to be appropriate for the care of many PWE. Technical improvements, extended use of videoconference and patient selection may improve results and patient and physician satisfaction.

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Section: Discussionmentioning

confidence: 99%

Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic

Conde‐Blanco

Centeno

Tió

et al. 2020

Epilepsy & Behavior

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“…In section Performance Analysis, the performance metrics are presented for the two different operating points, with a particular emphasis on the FDA-cleared mode. The performance analyses are presented over three groupings of the test data: for all the patients, for pediatric (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and for adult patients (21+). Finally, we present the performance of the seizure detection system during rest, as computed by the automated rest detection algorithm, and show the results for all three groupings.…”

Section: Performance Metricsmentioning

confidence: 99%

“…Over the past decade, wearable devices equipped with automated seizure detection algorithms have been suggested to complement and overcome limitations of the gold standard video-electroencephalography (v-EEG) performed in the Epilepsy Monitoring Unit (EMU) (8)(9)(10)(11)(12). Such devices target a continuous, remote, unobtrusive and less expensive monitoring of patients.…”

Section: Introductionmentioning

confidence: 99%

Prospective Study of a Multimodal Convulsive Seizure Detection Wearable System on Pediatric and Adult Patients in the Epilepsy Monitoring Unit

Regalia¹,

Caborni²,

LaFrance

et al. 2021

Front. Neurol.

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Background: Using machine learning to combine wrist accelerometer (ACM) and electrodermal activity (EDA) has been shown effective to detect primarily and secondarily generalized tonic-clonic seizures, here termed as convulsive seizures (CS). A prospective study was conducted for the FDA clearance of an ACM and EDA-based CS-detection device based on a predefined machine learning algorithm. Here we present its performance on pediatric and adult patients in epilepsy monitoring units (EMUs).Methods: Patients diagnosed with epilepsy participated in a prospective multi-center clinical study. Three board-certified neurologists independently labeled CS from video-EEG. The Detection Algorithm was evaluated in terms of Sensitivity and false alarm rate per 24 h-worn (FAR) on all the data and on only periods of rest. Performance were analyzed also applying the Detection Algorithm offline, with a less sensitive but more specific parameters configuration (“Active mode”).Results: Data from 152 patients (429 days) were used for performance evaluation (85 pediatric aged 6–20 years, and 67 adult aged 21–63 years). Thirty-six patients (18 pediatric) experienced a total of 66 CS (35 pediatric). The Sensitivity (corrected for clustered data) was 0.92, with a 95% confidence interval (CI) of [0.85-1.00] for the pediatric population, not significantly different (p > 0.05) from the adult population's Sensitivity (0.94, CI: [0.89–1.00]). The FAR on the pediatric population was 1.26 (CI: [0.87–1.73]), higher (p < 0.001) than in the adult population (0.57, CI: [0.36–0.81]). Using the Active mode, the FAR decreased by 68% while reducing Sensitivity to 0.95 across the population. During rest periods, the FAR's were 0 for all patients, lower than during activity periods (p < 0.001).Conclusions: Performance complies with FDA's requirements of a lower bound of CI for Sensitivity higher than 0.7 and of a FAR lower than 2, for both age groups. The pediatric FAR was higher than the adult FAR, likely due to higher pediatric activity. The high Sensitivity and precision (having no false alarms) during sleep might help mitigate SUDEP risk by summoning caregiver intervention. The Active mode may be advantageous for some patients, reducing the impact of the FAR on daily life. Future work will examine the performance and usability outside of EMUs.

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“…Seizure detection methods can be based on a range of techniques, including EEG signal analysis and non-EEG-based techniques (Ryvlin et al, 2018) such as automated analysis of recordings of digital videos (Karayiannis et al, 2006), detection of rhythmic, repetitive mHealth tools in the management of epilepsy (Lockman et al, 2011) or data obtained from surface electromyography (Beniczky et al, 2018;Szabó et al, 2015).…”

Section: Control Of Seizuresmentioning

confidence: 99%

mHealth tools in the management of epilepsy

Blek¹,

Zwoliński

2020

Journal of Epileptology

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Introduction. Epilepsy is a persistent neurological condition characterized by frequent seizures that are not triggered by an environmental or reversible stimulus.Although not yet widely used, mobile health (mHealth) innovations have enhanced epilepsy care and prevention and are expected to play an increasing role in the ownership of smartphones, wearable devices and innovation in medical technology. Aim. The present review paper aims to summarize the current state of knowledge regarding the use of mHealth tools in epilepsy management. Discussion and Conclusions. In this paper, we review available mHealth tools that influence key epilepsy management elements. These components include patient education, self-management directly affecting seizure control, diagnosis and therapy, and managing medical data. mHealth solutions are a promising approach to epilepsy self-management; further work is needed to explore their effectiveness.

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Seizure detection and mobile health devices in epilepsy: Update and future developments

Cited by 15 publications

References 12 publications

Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic

Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic

Prospective Study of a Multimodal Convulsive Seizure Detection Wearable System on Pediatric and Adult Patients in the Epilepsy Monitoring Unit

mHealth tools in the management of epilepsy

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