Seizure 'forecasting': Device worn on wrist helps people with epilepsy predict and prepare for seizures

Worn like a watch, the wearable monitor is a non-surgical alternative to a neurostimulation implant.

Chris Arnold 3 minute read November 11, 2021
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Many people with epilepsy do not want an invasive neurostimulation implant, but the wearable alternative is worn like a standard watch. GETTY

A new study by the Mayo Clinic in Rochester, Minnesota, suggests seizures can be detected early using a wrist-worn monitoring device. 

Researchers followed six patients with drug-resistant epilepsy between six months and one year as they wore the device, which alerted them about 30 minutes prior to a seizure. 

The device worked well for five of the six participants — each of whom also had a neurostimulation device previously implanted in their bodies, which confirmed to scientists that a seizure had occurred and its severity. 

“Just as a reliable weather forecast helps people plan their activities, so, too, could seizure forecasting help patients living with epilepsy adjust their plans if they knew a seizure was imminent,” Benjamin Brinkmann, PhD, an epilepsy scientist at Mayo Clinic and the senior author of the study, says. “This study using a wrist-worn device shows that providing reliable seizure forecasts for people living with epilepsy is possible without directly measuring brain activity.”

The Mayo Clinic study was first published in the peer-reviewed journal Scientific Reports.

The wrist monitors collected data by checking electrical characteristics of the patients’ skin, blood flow, temperature, heart rate, and movement, essentially like a fancier Fitbit. The wearable worked in tandem with the neurostimulation to first predict when a seizure would happen, then confirm that it had passed. 

The study says many people with epilepsy do not want an invasive neurostimulation implant, but the wearable alternative is worn like a standard watch, without the need for any surgical procedure. 

“We hope this research with wearable devices paves the way toward integrating seizure forecasting into clinical practice in the future,” Brinkmann said.

Although the study size is small at only six patients, researchers said they are confident the findings will be similar for a larger population.

These results provide the first clear evidence that direct seizure forecasts are possible using wearable devices in the ambulatory setting for many patients with epilepsy,” said Brinkmann. 

Seizures are caused by a sudden jolt of electrical activity in the brain, which disturbs the way brain cells communicate with one another. Depending on the part of the brain in which this happens, different effects can take place. Frontal lobe seizures can cause head movement, unresponsiveness, screaming or laughter, and repetitive movements, according to the Mayo Clinic.  Seizures in the temporal lobe, toward the middle of the brain, result in a rush of emotion such as fear or joy, smelling or tasting something that is not there, or a similar feeling in your gut to being on a roller coaster. 

In Canada, roughly 260,000 people have epilepsy, reports the Canadian Epilepsy Alliance. Of those, 30 per cent or 78,000 have drug-resistant epilepsy, similar to the patients in the study. Drug-resistant epilepsy is, as it sounds, resistant to standard treatments for the condition. The condition occurs when standard treatments, including drugs, are not able to prevent seizures. Treatment options for those with drug resistance include surgeries, medically managed diet therapy, and nerve stimulation. 

There is also a difference between the aforementioned types of epilepsy and photosensitive epilepsy, the type typically associated with fast, flashing lights. 

Photosensitive epilepsy is more common in children and young adults, with girls being more affected than boys. Fewer than five per cent of all people with epilepsy are photosensitive.