Inaccurate subjective seizure counting poses treatment and diagnostic challenges and thus suboptimal quality in epilepsy management. The limitations of existing hospital- and home-based monitoring solutions are motivating the development of minimally invasive, subscalp, implantable electroencephalography (EEG) systems with accompanying cloud-based software. This new generation of ultra–long-term brain monitoring systems is setting expectations for a sea change in the field of clinical epilepsy. From definitive diagnoses and reliable seizure logs to treatment optimization and presurgical seizure foci localization, the clinical need for continuous monitoring of brain electrophysiological activity in epilepsy patients is evident. This paper presents the converging solutions developed independently by researchers and organizations working at the forefront of next generation EEG monitoring. The immediate value of these devices is discussed as well as the potential drivers and hurdles to adoption. Additionally, this paper discusses what the expected value of ultra–long-term EEG data might be in the future with respect to alarms for especially focal seizures, seizure forecasting, and treatment personalization.
- A new generation of subscalp, continuous brain monitoring systems have the potential to advance treatment and diagnosis in epilepsy
- First studies comparing subscalp recordings with scalp EEG are favorable and show that seizures can be documented electrographically
Adoption of subscalp, ultra–long-term EEG monitoring may cause a shift from subjective seizure reporting to objective seizure counting
- The true value of ultra–long-term EEG has yet to be proven; more data collected over long periods of time are essential to show the benefit
Jonas Duun-Henriksen, Maxime Baud, Mark P. Richardson, Mark Cook, George Kouvas, John M. Heasman, Daniel Friedman, Jukka Peltola, Ivan C. Zibrandtsen, and Troels W. Kjaer.
Published on 22 Aug 2020