Seizure detection: Safety in epilepsy
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The Tele-epilepsy consortium realized Nightwatch, an easy to use high-tech bracelet, wirelessly connected to a detector. Nightwatch reliably reports 85 percent of the serious nightly tonic-clonic epileptic seizures. This reliability is a multitude of that of, for instance, the motion mats underneath the mattress, an often-used resource to detect epileptic seizures.

Sudden unexpected death in epilepsy (SUDEP) is a major cause of death amongst epilepsy patients. Patients with an intellectual disability and untreatable epilepsy have a chance up to 20 percent to die from SUDEP. Nightwatch can be widely deployed for adults, both in institutions and at home. Researchers believe that unexpected nightly deaths amongst epilepsy patients will decrease significantly thanks to Nightwatch.

The patient wears the bracelet at night. Nightwatch’ operation is based upon recognizing two essential characteristics of seizures: a deviating heartbeat in combination with shocking movements. The bracelet wirelessly sends an alarm signal to caregivers who can then provide the required care. Nightwatch is already commercially available.

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Follow-up research

Whereas Nightwatch now generates separate alarms based on the heartbeat sensor and the motion sensor, the consortium is currently researching how these two can intelligently work together for even better results. The consortium also works on improving the alarm based on sound and video, in de future to be combined with the current sensors. The ultimate goal is to make the interpretation of the signals patient-specific. The use of Nightwatch by other groups – for instance children – and for other types of epileptic seizures is currently being investigated. After all, the manifestation of a seizure does not always say much about the seriousness and the risk of the seizure. Hardly visible or audible seizures can also have serious consequences. The ultimate goal is to reliably detect all risky seizures in all groups of patients. Because we consider it to be our duty to contribute to the optimal safeguarding of vulnerable patients.

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Know-how agenda neurology

The relevance of scientific research on seizures detection has been acknowledged by the committee Care Evaluation Neurology of the Dutch Association for Neurology. This committee has, together with professionals, patient support groups and health care insurers, established where in the daily practice of the neurologist there is a need for more scientific substantiation.

Inventory and prioritization of the subjects has resulted in the Know-how agenda Neurology, containing the top twelve of the most urgent research topics. ‘What is the cost effectivity of selective and specific monitoring of epileptic seizures in the intellectually disabled compared to conventional audio monitoring?’ is one of the twelve subjects in the know-how agenda.