Seizure detection and alerting devices hold promise for preventing sudden death in epilepsy.
Cassandra Kazl, MD; and Daniel Friedman, MD, MSc | Practical Neurology | November/December 2018, Volume 17, Number 9 | Retrieved From: http://practicalneurology.com/2018/12
For many of the 3 million adults and 470,000 children in the US (1.2% of the population) living with active epilepsy,1 the unpredictable nature of seizures is unsettling for both patients and caregivers. Seizures can have many immediate negative consequences; the most significant is sudden unexpected death in epilepsy (SUDEP), the most common cause of premature death among people with epilepsy.2 The pathophysiology of SUDEP often includes a terminal seizure.3,4 Interventions that reduce seizure frequency (eg, epilepsy surgery or add-on drug therapy) also reduce SUDEP rates.5,6
The seizures that cause the majority of SUDEP cases are often unattended. Most SUDEPs occur during unsupervised times, and most commonly, the decedent is found by family or caregivers in the morning.3,7 Persons with a history of seizures during unsupervised times may also be more vulnerable; a history of nocturnal seizures increases SUDEP risk.8 Increased nighttime supervision appears to be protective; having a roommate or use of a nocturnal listening device is associated with reduced SUDEP risk.9 This is likely because someone may be able to provide aid and resuscitation in the vulnerable postictal period when cardiopulmonary dysfunction may be reversible.4 Even tactile stimulation and repositioning can decrease postictal respiratory dysfunction.10
There has been a growing interest in seizure detection and alerting devices for use in the home to notify caregivers of a seizure and turn unwitnessed seizures into attended seizures, as a method to reduce SUDEP risk. With the help of innovations in health technology, mobile sensors, and smartphones, many devices are in development and some have been commercialized. Recently 2 such devices were approved by the FDA for use as adjuncts to seizure monitoring.