Implanted devices could improve epilepsy management

computer graphic of subcutaneous strip electrodes on the head

Continuous monitoring of brain activity could improve quality of life for people with epilepsy, say clinicians

A new opinion paper in the journal Neurology calls for broader use of technology for epilepsy treatment. As a new era in personalized medicine dawns, epileptologists are calling for implantable devices to provide long-term monitoring of brain activity.

Surprisingly, people with epilepsy often do not remember having a seizure and typically report only fifty percent of events. Implanted devices can give a true seizure count but are currently typically offered only after multiple epilepsy treatments have failed.

The authors from University Hospital of Bern, the Wyss Center for Bio and Neuroengineering and the University of California, San Francisco, argue that a device that provides long-term electroencephalography (EEG) recordings in people with epilepsy could help optimize medical treatment. The same device could also help neurosurgeons plan for surgery by collecting information on brain function in an every-day home setting, rather than in the constrained environment of a hospital.

In the longer term, such devices could even enable seizure forecasting and give epilepsy patients themselves a more central role in deciding when and how to adjust their treatment to minimize the chances of a seizure occurring. In theory, medication could be tailored to days of high seizure risk.

In response to this clinical need, the Wyss Center is developing a minimally invasive device that would allow long-term, out-patient monitoring of people with epilepsy.

The Wyss Center team is working alongside clinical and academic partners at the University Hospital of Bern (INSELSPITAL) and Lausanne University Hospital (CHUV). The device is currently in the design and development phase with the first clinical trials planned for early 2020.

The paper Gauging Seizure Risk by Maxime O. Baud and Vikram R. Rao is published in Neurology.

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