A seizure detection device that may help prevent SUDEP and fatalities in epilepsy
Interview with Dr. Evan Fertig:
What are some of the risks that patients who suffer seizures should be aware of?
Epilepsy is a neurological disorder that affects about 3 million people per year in the US. Epileptic seizures can cause physical injury. Sirven reported in 2010 that about 70,000 seizure related injuries “require treatment” per year, approximately 34,000 of which are defined as severe injuries and about 5000 are severe head injuries requiring neurosurgical intervention. There can also be up to 3000 deaths annually due to SUDEP.
Shockwaves went through the epilepsy community recently when new information came out on SUDEP (sudden unexpected death in epilepsy) as reported by Professor Semsarian of Australia. Could you explain the results to us?
A new Australian study points to a genetic relationship between SUDEP and Long QT Syndrome, an electrical disorder of the heart that causes potentially fatal irregular heart rhythms (arrhythmias). Professor Chris Semsarian, from the University of Sydney and the Centenary Institute, tested the genetic makeup of post mortem SUDEP victims and found that a significant portion of the subjects carried at least one of the gene mutations that cause Long QT. It is not yet recommended that individuals with epilepsy receive genetic testing. However, if the etiology of your epilepsy is unknown, this study encourages you to speak to your doctor about screening for Long QT syndrome.
What other steps can patients take to tackle these risks?
It is essential to take anti-seizure medication consistently, follow up regularly with your doctor and keep yourself well informed.
More recently, a growing number of electronic and mechanical devices are being designed and/or marketed as an added safeguard for patients with seizures and Epilepsy. These devices monitor the patient for seizure activity with the expectation that they will alert others when a seizure is occurring. That way medical attention can be sought in a timely manner if needed.
Tell us about the EpiLert study being conducted through the Northeast Regional Epilepsy Group in conjunction with the Hackensack University Medical Center.
Our research program is involved in testing the EpiLert device. We are hoping to collect data from 50 patients who have frequent tonic, clonic and/or unilateral seizures and who have come into our Long Term video Epilepsy monitoring unit for clinical purposes. Inclusion and exclusion will be determined upon admission into the clinic through a review of the individual’s medical history.
If someone decides to be part of this study and fulfills criteria, what should they expect?
Participants in the study will wear the device during the day, which is painless and relatively unobtrusive. The researchers will review the times any seizures occur. The video of the seizure will also be reviewed in order to characterize the clinical features of the seizures. The aim of the study is to determine how accurate the device is for recognizing seizures.
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Interview with Amos Shaham:
What is EpiLert?
EpiLert is a device worn like a bracelet that can detect the limb movements specifically associated with epileptic convulsions. It does this using a mathematical algorithm. It then sends a signal to alert caregivers within 20 seconds of seizure onset.
How did the initial idea for Epilert arise?
Prof. Uri Kramer, Pediatric Neurologist at Tel Aviv, Sourasky, Medical Center treats children with epilepsy and works closely with their families. He recognized the need for an alert device that would free families from having to supervise patients 24 hours a day, including at night. He approached me, seeking out my expertise in electronic engineering and explained what he was looking for this device to do.
Tell us more about how the device works
The movement sensor is worn like a watch and it transmits signals to the Alert unit that is with the caretaker. The device senses the onset of a seizure through the detection of seizure-specific limb movement and alerts the caregiver when the seizure begins. The device also records pertinent information regarding the seizures while it is occurring.
How is it powered?
The Sensor and the Alert unit both have a rechargeable ~48 hour battery and they can be charged via a USB plug from an electrical line or computer.
Is it waterproof?
It is drip proof, like similar electronics, however it is not completely water proof, so although it can be worn in all kinds of activity and weather, care should be taken with complete immersion in water.
Does the caretaker also wear a device?
The caretaker will hold onto the Alert Unit, which is the size of a cell phone. They can travel about 100 feet (the size of a large home) away with the Home model and the outdoor set will work via the cellular network allowing them to be further away.
Does it have false alarms?
The EpiLert has very few false alarms and the ones that do occur are all as a result of vigorous patient activities during ‘awake’ time. The reason that our device produces so few false alarms is because it has it’s a kind of “brain” that “learns.” The identification algorithm understands and distinguishes epilepsy movement from normal daily movement. We are the first in the world that came up with a working algorithm that can do that successfully!
How can someone acquire this device?
The EpiLert cannot be purchased right now because we are still in research mode and have not have produced a commercial product yet. It is not yet FDA approved, although we plan to submit it for approval soon. When it is ready for sale, it will cost about $500 and we expect it to be available in drug stores and online.
*Note that our medical group does not endorse any device in particular. We disclose that the Northeast Regional Epilepsy Group is working in conjunction with Hackensack University Medical Center on a research protocol to test the effectiveness of the EpiLert device that was discussed above. In future editions, we will be reviewing other seizure detection and preventative devices.
