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EPIVIEWS: Exploring Patient Impact & Value in Epilepsy Wearables for Seizure Monitoring


John David Damalerio, Royal College of Surgeons in Ireland

Academic Supervisor

Prof Colin Doherty, RCSI


€27,000 over 3 years

About the Project

Digital tools for epilepsy range between patient education programmes, self-monitoring systems, and wearables for seizure detection.

The timely detection of seizures can not only act as an outcome measure but also reduce the risk of further injury or even SUDEP events. However, only approximately half of patients keep a seizure diary, and the accuracy of diaries is dependent on patient/carer awareness of their seizures. Therefore there is a need for accurate, automated seizure detection devices which have the potential to improve quality of life for patients and caregivers.  

The gold standard for the detection of epileptic seizures is the use of video-electroencephalography (EEG). However this largely takes place in inpatient settings, is expensive, time-consuming, and places a burden on patients. Efforts more recently have focussed on the development of non-EEG-based seizure detection systems. A recent systematic review identified 12 studies evaluating the use of wearables for seizure detection and noted poor quality of reporting on the validity of such devices, and a lack of evaluation in free-living (real world) contexts. Some studies have also recommended the need for long term follow-up to assess false alert ratios and to examine the value of these devices.

One such wearable device for the automatic detection of seizures is the Embrace 2 wrist-worn device by Empatica. This FDA cleared device alerts patients and caregivers to a seizure detected via accelerometer and electrodermal data processed with a machine learning classification model. A preliminary evaluation in the free-living setting has been conducted with three participants by the manufacturers. However there is a clear need for further research to understand the validity of the device, and the clinical impact that can be delivered from these wearable seizure detection systems.

This research will have two key aims:

  1. What is the validity of the Empatica Embrace2 wearable device in detecting generalised tonic/clonic seizures?
  2. What value / clinical impact is there in using wearable seizure monitoring devices in the management of epilepsy?