Non-EEG seizure-detection systems and potential SUDEP prevention: State of the art

PURPOSE There is a need for a seizure-detection system that can be used long-term and in home situations for early intervention and prevention of seizure related side effects including SUDEP (sudden unexpected death in epileptic patients). The gold standard for monitoring epileptic seizures involves video/EEG (electro-encephalography), which is uncomfortable for the patient, as EEG electrodes are attached to the scalp. EEG analysis is also labour-intensive and has yet to be automated and adapted for real-time monitoring. It is therefore usually performed in a hospital setting, for a few days at the most. The goal of this article is to provide an overview of body signals that can be measured, along with corresponding methods, state-of-art research, and commercially available systems, as well as to stress the importance of a good detection system. METHOD Narrative literature review. RESULTS A range of body signals can be monitored for the purpose of seizure detection. It is particularly interesting to include monitoring of autonomic dysfunction, as this may be an important patho-physiological mechanism of SUDEP, and of movement, as many seizures have a motor component. CONCLUSION The most effective seizure detection systems are multimodal. Such systems should also be comfortable and low-power. The body signals and modalities on which a system is based should take account of the user's seizure types and personal preferences.