A warning of an impending seizure has little value unless something is done to forestall the
seizure or minimize its impact. At the simplest level, a warning of a seizure could enable a
person to withdraw to a safer or less embarrassing environment for a seizure. The time
horizon for the warning has to allow for such actions, but not so long as to produce ongoing
anxiety.
A collaborative European effort called EPILEPSIAE (http://www.epilepsiae.eu, an acronym
for “Evolving Platform for Improving Living Expectation of Patients Suffering from IctAl
Events” is collaborating with Micromed S.P.A.® (http://www.micromed-it.com/) to develop
a database of ictal events in order to test prediction algorithms
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. A second goal has been
development of a portable EEG recorder using low power Bluetooth transmission
technology. Clinical trials of seizure prediction using this device are in planning. In another
effort, the National Institutes of Health has funded “The International Epilepsy
Electrophysiology Database,” a platform based on cloud computing, to share large archives
of expertly annotated human and animal intracranial EEG for collaborative research and
benchmarking device performance. This database, promoted by the International Seizure
Prediction Group, is working to share resources with EPILEPSAE.
NeuroVista® has developed a seizure advisory system, validated in canines with epilepsy
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that has progressed to clinical trials in three hospitals in Australia
(http://clinicaltrials.gov/ct2/show/NCT01043406?term=neurovista&rank=1). Recording
strips of 16 electrodes are implanted subdurally, in and around the seizure onset region.
These electrodes connect to a subclavicular unit that transmits EEG to a belt-worn device.
The external device continuously analyzes intracranial EEG, and uses algorithms to
determine the likelihood of seizure onset. The user is informed of seizure probability by a
display of colored lights: blue for low likelihood, white for moderate likelihood or red for
high likelihood and is provided with an audio alert when the seizure likelihood changes.