Abstracts

Rationale: We see an increasing interest in seizure detection devices, which seems to be beneficial for both epileptic patients and their caregivers/families. Our study aimed to evaluate the clinical utility of seizure detection devices in patients' home environments. 

Methods: We used the seizure detection device Embrace2 produced by Empatica. We distributed seizure detection devices Empatica2 among epileptic patients. All patients were evaluated as having tonic-clonic seizures with the minimal frequency of one tonic-clonic seizure per month. The patients were informed about the use of detectors; all costs associated with acquiring Empatica2 devices were paid within the study. The study duration was four months, but the patients were allowed to leave the study whenever.

Results: We screened 40 patients, but ten patients decided not to participate in the study. The most common reason was misunderstanding the device's function (the patients/caregivers supposed that the detectors are designed to predict the seizures). A total number of 30 sensors were handed out among 21 adult patients (median age 32 years; min 18 years, max 65 years) and 9 children (median age 11 years, min  7 years, max 15 years). The adult patients had seizure frequency as follows: 17 (76%) patients 1 to 4 seizures per month, 3 (14%) 5 to 10 seizures per month, and 2 (10%) patients referred seizure frequency ≥ 10 seizures per month. In children, the seizure frequency was 1 to 10 seizures per month in 6 children, 3 children had more than 10 seizures per month. Eleven (37%) patients finished the four-month study; the resting 19 patients decided to leave the study prematurely because of the inefficacy of the detection device or the technical problems with the device. After the four-month study period, 4 (36%) out of 11 patients evaluated the device positively, i.e., the device fulfilled the expectation. The four (36%) patients were neutral about the detector use, and the resting 3 (27%) patients were negative. Five (45%) patients would recommend the detector to their friends to try, and 6 (55%) would not recommend it. When the patients were asked whether the sensor helped them to decrease their fear of ongoing seizures, 4 (36%) patients answered positively, 6 (55%) patients negatively, and 1 (9%) was unsure. The patients often complained about falsely positive reports and technical problems associated with detector use.

Conclusions: Seizure detection devices seem to be a promising tool for minimizing patients' fear of epileptic seizures. They can be helpful in some patient subgroups. However, their clinical benefit is lower than we would expect, and further research is needed to improve their accuracy and technical properties.

Funding: The study was supported by inner grant of Masaryk University.