Provider and Patient Opinions on Real-Time Seizure Detection via Over-the-Ear Device
Pooja Venkatesh1, Zhuoran Yao1, Jamie Lehnen1, Kan Ding2, VP Nguyen3, Jay Harvey2
1UT Southwestern Medical Center, 2Department of Neurology, UT Southwestern Medical Center, 3Department of Computer Science and Engineering, University of Texas at Arlington
Objective:

To examine epileptologist opinions and patient experiences regarding an over-the-ear real-time seizure detection device.

Background:

Our team developed BrainSD, a behind-the-ear seizure monitor that detects EEGs with four scalp contacts. BrainSD maximizes detection accuracy and usability for clinicians, and comfort and ease-of-use for patients. It was tested on 33 patients admitted to the Epilepsy Monitoring Unit (EMU) at a Level 4 Epilepsy Center. BrainSD was worn for 42 hours on average and recorded 14 seizure events.

Design/Methods:

An anonymous 14-question survey was offered to study participants at the end of the study. Subsequently, nine epileptologists were invited to a one-hour focus group to obtain opinions regarding portable seizure detection devices.

Results:

Thirty (91%) of thirty-three participants who wore BrainSD completed the post-survey. Of the thirty, seven (23.3%) strongly agreed and fifteen (50%) agreed that BrainSD was comfortable. Discomfort was expressed (16.7%) due to pressure, and the adhesive glue. Twelve (40%) strongly agreed and fourteen (46.7%) agreed that BrainSD was easy to use. Twelve (40%) patients said they would wear BrainSD continuously for over a week. Eight (26.7%) strongly agreed and ten (33.3%) agreed that BrainSD is socially acceptable to wear in public. Nine (30%) strongly agreed and ten (33.3%) agreed that they slept well while wearing BrainSD. For potential BrainSD improvements, three (10%) inquired about an auxiliary mobile application and six (20%) about seizure prediction and alerting.

Providers expressed interest in a device that detects non-motor focal seizures; uploads recordings in real-time for viewing; alerts patients before an epileptic event; and allows patients to log their events. Hesitancies with over-the-ear devices included the risk of false positive rates with the implemented 2-channel EEG.

Conclusions:

BrainSD has the features that users desire, is acceptable and comfortable for patients, and meets epileptologists’ expectations. More features will be considered to optimize BrainSD in the future.

10.1212/WNL.0000000000203294