Ambulatory epilepsy monitoring: support and challenges for use in Phase II tests
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Phase II testing to localise the epileptogenic zone in drug-resistant epilepsy (DRE) is currently carried out as an inpatient procedure in dedicated telemetry units at hospital. During intracranial video-EEG recordings, the patient might be monitored for up to 3 weeks during which they are confined to a bed, with up to 256 electrodes directly connecting their brain to EEG acquisition
hardware. Although intracranial recordings can imply a high burden on the patient due to surgery, it must be balanced against the relatively high success rate of epilepsy surgery and the possibility of seizure freedom. Recent advances have enabled the commercialisation of ambulatory epilepsy-monitoring technologies, including wearable devices and implantable systems. Currently, anecdotal evidence supports the use of these devices for Phase II testing at home in selected cases, with the
potential in future of increasing adoption. This would reduce burden on patients and the healthcare system while yielding improved outcomes for localisation of the epileptogenic zone. In this review, we evaluate these devices and their potential role in Phase II assessment of epilepsy surgery candidates from technical, health economic, and patient perspectives. A definite clinical need and health-economic advantages for ambulatory epilepsy monitoring, have suggested an emerging trend
for these devices. However, we also highlight limitations in channel count and brain coverage with the current technology and suggest that dedicated trials are required to validate the use of these devices for Phase II tests by leveraging ultra-long term recordings.
hardware. Although intracranial recordings can imply a high burden on the patient due to surgery, it must be balanced against the relatively high success rate of epilepsy surgery and the possibility of seizure freedom. Recent advances have enabled the commercialisation of ambulatory epilepsy-monitoring technologies, including wearable devices and implantable systems. Currently, anecdotal evidence supports the use of these devices for Phase II testing at home in selected cases, with the
potential in future of increasing adoption. This would reduce burden on patients and the healthcare system while yielding improved outcomes for localisation of the epileptogenic zone. In this review, we evaluate these devices and their potential role in Phase II assessment of epilepsy surgery candidates from technical, health economic, and patient perspectives. A definite clinical need and health-economic advantages for ambulatory epilepsy monitoring, have suggested an emerging trend
for these devices. However, we also highlight limitations in channel count and brain coverage with the current technology and suggest that dedicated trials are required to validate the use of these devices for Phase II tests by leveraging ultra-long term recordings.
Date Acceptance
2026-09-07
Citation
Frontiers in Neurology
ISSN
1664-2295
Publisher
Frontiers Media S.A.
Journal / Book Title
Frontiers in Neurology
Copyright Statement
Copyright This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
License URL
Publication Status
Accepted