Non-electroencephalography-based seizure detection

PURPOSE OF REVIEW: There is need for automated seizure detection using mobile or wearable devices, for objective seizure documentation and decreasing morbidity and mortality associated with seizures. Due to technological development, a high number of articles have addressed non-electroencephalography (EEG)-based seizure detection. However, the quality of study-design and reporting is extremely heterogeneous. We aimed at giving the reader a clear picture on the current state of seizure detection, describing the level of evidence behind the various devices.

RECENT FINDINGS: Fifteen studies of phase-2 or above, demonstrated that non-EEG-based devices detected generalized tonic-clonic seizures (GTCS) with high sensitivity (≥90%) and low false alarm rate (FAR) (down to 0.2/day). We found limited evidence for detection of motor seizures other than GTCS, mostly from subgroups in larger studies, targeting GTCS. There is little evidence for non-EEG-based detection of nonmotor seizures: sensitivity is low (19-74%) with extremely high FAR (50-216/day).

SUMMARY: Detection of GTCS is reliable and there are several, validated devices on the market. However, detection of other seizure types needs further research.