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News from the American Epilepsy Society Annual Meeting
Researchers Develop Wearable EEG Device to Record Seizure Activity

ARTICLE IN BRIEF

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THE EEG PATCH is designed to be fixed to a part of the patients scalp where seizures are known to originate, based on EEG recorded in-hospital during a traditional epilepsy diagnosis.

Researchers have developed a wearable electroencephalogram device that can detect and record seizure activity in epilepsy patients in the outpatient setting.

Researchers have developed a wearable electroencephalogram (EEG) device that can detect and record seizure activity in epilepsy patients in the outpatient setting, they reported earlier this month at the annual meeting of the American Epilepsy Society in Philadelphia.

The so-called EEG Patch, a small, waterproof, scalp-mounted device, was designed to help patients more accurately track their seizures, Mark Lehmkuhle, PhD, a research assistant professor in neurosurgery at the University of Utah School of Medicine in Salt Lake City, who presented the findings at the meeting, told Neurology Today.

The EEG Patch is designed to be fixed to a part of the patient's scalp where seizures are known to originate, based on EEG recorded in-hospital during a traditional epilepsy diagnosis. The device is waterproof and can be worn for up to seven days without needing to be removed or recharged, Dr. Lehmkuhle said.

“There have been quite a few studies to show that seizure diaries can be inaccurate or in some cases even misleading,” Dr. Lehmkuhle said. “A lot of seizures are nonconvulsive or subclinical, and a person may not even know they're having a seizure. With this device, we're trying to help people keep track of their seizures better so that they can report them to their epileptologist. The epileptologist would then have a more accurate report of how many seizures a person is having, and be able to fine-tune a person's treatment based on that report.”

PILOT TRIAL UNDERWAY

The device was manufactured by Epitel Inc., which was founded in 2007 to develop wireless EEG recording technology for research on animal models of epilepsy in the lab of F. Edward Dudek, PhD, a professor of neurosurgery at the University of Utah and a coauthor on the abstract presented at the meeting. It is currently being tested in a small pilot feasibility trial led by Mark C. Spitz, MD, a professor of neurology at the University of Colorado in Denver.

The pilot trial will compare EEG recordings of seizures from the EEG Patch to seizure activity recorded for between three and seven days using 26-channel wired EEG at the University of Colorado's epilepsy monitoring unit, Dr. Lehmkuhle said.

Dr. Spitz told Neurology Today that the results are still preliminary and more participants are needed, but the device appears to be performing as expected so far. None of the patients have had a skin reaction from having the device fixed to the scalp (with the same adhesive used to fix the electrodes in continuous EEG), which had been a concern, he noted.

Presenting preliminary data in a poster session at the meeting, Dr. Lehmkuhle said three of four patients had seizures in the EEG monitoring unit, and the waveform recordings from the wired EEG and the EEG Patch looked very similar. “We think we can see the simultaneously recorded seizures in both the wireless and the wired EEG channels,” he said.

In a second test of the device's feasibility, the researchers will present the seizure data recorded by the EEG Patch, along with some catch trials of interictal or “normal” EEG, to an epileptologist in a blinded manner. The epileptologist will have to determine whether a seizure is present. If the specialist is able to correctly identify seizure activity, that would suggest that the EEG Patch — which uses a single channel of EEG instead of the standard 26 channels in wired EEG — is reliable for recording seizure activity. That part of the trial has not yet begun, Dr. Lehmkuhle said.

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DR. MARK LEHMKUHLE: “A lot of seizures are nonconvulsive or subclinical, and a person may not even know theyre having a seizure. With this device, were trying to help people keep track of their seizures better so that they can report them to their epileptologist. The epileptologist would then have a more accurate report of how many seizures a person is having, and be able to fine-tune a persons treatment based on that report.”

EXPERTS COMMENT

Commenting on the device, Robert S. Fisher, MD, PhD, FAAN, the Maslah Saul professor of neurology and director of the Stanford Epilepsy Center at Stanford University Medical Center, said: “There is a major need for new EEG technology that can be used long-term in the outpatient environment. Having a low-profile way of recording EEG long-term would help us with diagnosis of seizures and counting numbers of seizures, and eventually it might, as technology improves, even help us with seizure prediction.”

Dr. Fisher disclosed that he holds stock options in two companies that develop EEG equipment, Advanced Neurometrics Inc. and Zeto Inc. Neither was involved in the development of the EEG Patch.

The device “appears to be potentially very good at counting seizures where you know the location of the seizure a priori,” Dr. Fisher added. However, “it might not be quite as applicable to making a diagnosis of epileptic versus non-epileptic events, because in that setting you wouldn't really know where to put the one electrode.”

Another question, he said, is whether the device “continues giving high-quality EEG signal day after day, or whether it becomes prone to acquiring more artifact and becoming more difficult to interpret.”

Joseph I. Sirven, MD, FAAN, a professor of neurology at the Mayo Clinic in Scottsdale, AZ, agreed that the device appears promising. “This is precisely where everyone in the field wants to go,” he said. “If it's not that intrusive or problematic, then this is a rather striking upgrade in terms of getting EEG data that we just have never had before.”

EXPERTS: ON A WEARABLE EEG PATCH TO RECORD SEIZURE ACTIVITY

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DR. ROBERT S. FISHER said the device “appears to be potentially very good at counting seizures where you know the location of the seizure a priori. However, it might not be quite as applicable to making a diagnosis of epileptic versus non-epileptic events, because in that setting you wouldnt really know where to put the one electrode.”

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DR. JOSEPH I. SIRVEN: “This is precisely where everyone in the field wants to go. If its not that intrusive or problematic, then this is a rather striking upgrade in terms of getting EEG data that we just have never had before.”

LINK UP FOR MORE INFORMATION:

•. American Epilepsy Society annual meeting abstract: Lehmkuhle M, Elwood M, Wheeler J, et al. Development of a discrete, wearable, EEG device for counting seizures: http://bit.ly/wearableEEG
    •. Neurology Today: “Electronic Sensors Break New Ground in Neurology Practice and Research”: http://bit.ly/NT-wearables