Living with epilepsy is hard at the best of times, but in poor countries where the disorder is often poorly understood and treatments are scarce, it can be deadly. Bhutan, a country of nearly a million people, doesn’t have a single neurologist, for example. But a new project, funded by the Canadian government, aims to use a standard Android smartphone to help diagnose epilepsy anywhere.
The Bhutan Epilepsy Project will use a portable brain scanner developed by Jacob Eg Larsen and Arkadiusz Stopczynski at the Technical University of Denmark, near Copenhagen. The system consists of a smartphone and simple electrode skullcap to monitor brain signals. It performs electroencephalography (EEG) without any bulky medical equipment.
Neurologists are currently testing the device in clinical trials on people with normal brains and people with brain abnormalities. The work is taking place in Boston, Massachusetts, and in Copenhagen. Measurements made by the smartphone EEG will be calibrated against readings from standard equipment.
Once these trials are complete, a team will travel to Bhutan, where they will work with psychiatrists at the National Referral Hospital in Thimphu, the nation’s capital.
Are you paying attention?
Farrah Mateen, a neurologist at Massachusetts General Hospital and one of the project’s leaders, says mobile epilepsy diagnoses will be particularly beneficial for young children, whose seizures often take different forms to those of adults, with many small, non-violent seizures every day that can be mistaken for not paying attention.
“‘Absence seizures’ or petit mal seizures are more like staring spells and are particularly important. Kids can be accused of not paying attention in school, but they’re actually having epilepsy. If those can be caught, it’s great,” she says.
Bhutan is not the only country where mental health is largely neglected. A study in The Lancet published in 2012 found that epilepsy is particularly common in poor areas of the world, and that people suffering from the disease in such places are more likely to die than people in the rich world, as it often goes untreated. This is despite the fact that medication for treating epilepsy is cheap and widely available. Among other things, the study suggested that the situation could be improved through better diagnoses – exactly what the Bhutan Epilepsy Project aims to do.
Education is key
Jerome Engel, a neurologist at the University of California, Los Angeles, says that while EEG is a useful tool, it’s also easy to misinterpret the results of the test if physicians are not properly trained. “If this is to be done on a broad scale there need to be careful controls,” he says.
Engel says educating people about epilepsy is the first and most important step to improving conditions for those living with it in developing countries. A portable device like that piloted in the Bhutan project could help with that effort, by giving doctors a tangible way to show how the disease affects the brains of those who sufferfrom it.
The Technical University of Denmark’s system is not the only one aiming to read the brain with smartphones. Keita Honda and Suguru Kudoh of Kwansei Gakuin University in Hyogo prefecture, Japan, presented Air Brain at the BodyNets conference in Boston in October last year. That system aims to correlate human activity, measured with the sensors embedded in any smartphone, with the brain activity readings obtained through mobile EEG.