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Abstracts

EpiCare@Home: Update on How Wearable Seizure Monitoring for Children and Adults with Epilepsy Can Improve Delivery of Care

Abstract number : 3.081
Submission category : 2. Translational Research / 2B. Devices, Technologies, Stem Cells
Year : 2023
Submission ID : 1040
Source : www.aesnet.org
Presentation date : 12/4/2023 12:00:00 AM
Published date :

Authors :
Presenting Author: Benjamin Vandendriessche, PhD – Byteflies

First Author: Julie Nys, – Byteflies

Waverlee Harvey, Bsc – Product manager, Byteflies; Renee Proost, MD – Neurologist and PhD candidate, Pediatric Neurology, University of KU Leuven; Nicolas Zabler, MS – PhD student, Epilepsy Center, University Hospital Freiburg; Benjamin De Ridder, MS – EEG technician, Pediatric Neurology, University of Ghent; Jo Sourbon, Dr., MD – Neurologist, Post-doc, Center for Medical Genetics, Development and Regeneration, Pediatric Neurology, Ghent University Hospital; University Hospital of KU Leuven; Matthias De Wachter, MD – Neurologist, Pediatric Neurology, University Hospital of Antwerpen; Guy Fonteyn, MD – Neurologist, Neurology, AZ Damiaan hospital; Adinda De Pauw, MD – Neurologist, Neurology, AZ Damiaan Hospital; Antoon Meylemans, MD – Neurologist, Neurology, AZ Damiaan Hospital; Dominque Van Diest, MD – Neurologist, Neurology, AZ Damiaan Hospital; Chantal Depondt, Prof. dr., MD – Professor, Service de Neurologie, Hôpital Erasme, Université Libre de Bruxelles; Jean Delbecq, MD – Neuropsychiatrist, Neurology, Hospital of Halle; Pieternel Van Herpe, MD – Neurologist, Neurology, AZ Sint-Maarten Hospital; Riem El Tahry, Prof. dr., MD – Professor, Reference center for refractory epilepsy, Cliniques universitaires Saint-Luc; Susana Ferrao Santos, Prof. dr., MD – Professor, Reference center for refractory epilepsy, Cliniques universitaires Saint-Luc; Sarah Weckhuysen, Prof. dr., MD – Professor, Translational Neuroscience, University Hospital of Antwerpen; Anna Jansen, Prof. dr., MD – Professor, Pediatric Neurology, University Hospital of Antwerpen; Patrick Verloo, MD – Neurologist, Pediatric Neurology, University Hospital of Gent; Helene Verhelst, Prof. dr., MD – Professor, Pediatric Neurology, University Hospital of Gent; Hans Faber, MD – Neurologist, Epilepsy Center, University Hospital Freiburg; Martin Hirsch, MD – Neurologist, Epilepsy Center, University Hospital Freiburg; Andreas Schulze-Bonhage, Prof. dr., MD – Professor, Epilepsy center, University Hospital Freiburg; Katrien Jansen, Prof. dr., MD – Professor, Pediatric Neurology, University Hospital KU Leuven; Lieven Lagae, Prof. dr., MD – Professor, Pediatric Neurology, University Hospital KU Leuven; Benjamin Vandendriessche, Associate Professor, PhD, MS – Chief Medical Officer, Byteflies and Case Western Reserve University

Rationale: For people with epilepsy, the journey to adequate treatment and an acceptable quality of life may be long and cumbersome. Hence, we developed EpiCare@Home based on extensive clinical research (NCT04284072, NCT04642105, NCT04584385) as an end-to-end remote monitoring service to support neurologists and generate insights in seizure types, frequency and burden outside the hospital over longer periods of time.

Methods: After a telemonitoring prescription by a neurologist, patients were set up with unobtrusive wearable technology (Sensor Dot) during a consultation or directly at home for one to three days up to two weeks. Sensor Dot measures 2-channel behind-the-ear EEG, ECG (heart rate, respiration rate), and motion (accelerometer, gyroscope and activity index). Patients or caregivers used the Assistant App as a digital seizure diary and the healthcare provider used the EpiCare@Home dashboard to manage patients, and visualize recorded raw data with annotated potential epileptic events.

Results: A total of 50 subjects diagnosed with (or a suspicion of) generalized (47) or focal-onset epilepsy (3), including explorative cases of rare developmental encephalopathic epilepsies (DEEs) (6). A retrospective case review was done to assess the clinical and patient value. We captured 1473 potential epileptic events, including typical and atypical absences, GTCs, and a FIA in which the epileptic activity was linked to a diary event (clinical seizure), whereas in other cases these events were unclear in nature or missed by the patient. In 82% of cases (41), a positive clinical impact, defined as the ability of the real-world data to support a clinical decision, was achieved after a multi-day follow-up outside the hospital. In the remaining 18% of cases, only patient value (related to the quality of life, comfort, ease of mind, fewer hospital visits and improved dialogue with doctor) was achieved but no clinical decisions were made due to low EEG quality (3), no novel insights (2) or an uncertainty (4) around the epilepsy diagnosis.

Conclusions: We demonstrate the potential importance and clinical utility of remote patient monitoring in epilepsy care. In 82% of cases the real-world data recorded by EpiCare@Home resulted in a direct positive clinical impact by supporting timely diagnostic decision making that can improve the standard of care in epilepsy. Currently, we are exploring in more detail the value of remote monitoring, especially at night, in the management of children with DEEs.

Funding: None

Translational Research