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If you have epilepsy, your body sends signals before the onset of a seizure. These signals can range from subtle changes in heart rate to more noticeable auras (warnings or feelings of an oncoming seizure). Not everyone can clue into these signals—particularly children or people with intense seizures that may incapacitate them quickly.

Seizure alert devices are tools that can help people with seizure disorders and those around them get notifications before the onset of a seizure. These notifications can provide valuable time to get help, create a safe environment, prevent injury, and even enable quick treatment.

This article discusses how seizure alert devices work and reviews some of the most common devices.

What Are Seizure Alert Devices?

Seizure alert devices are tools that warn people with seizures and those around them about oncoming seizure activity. This can give you, or your family and friends, time to get to a safe place, take medications, or call for help.

Many seizure devices exist; one 2021 study identified 23 commercially available seizure detection devices. The majority of these devices were most effective in detecting tonic- (muscle stiffening) clonic (muscle jerking or twitching) type seizures. Different devices use different detection methods, including:

  • Movement sensors
  • Sensors for autonomic nervous system changes
  • Electroencephalogram (EEG) sensors
  • Audio sensors

Benefits

It can be difficult for people with epilepsy to recognize and respond to oncoming seizures. Some seizure activity is subtle and may not be noticeable to the person having the seizure or those around them.

In one study, over 25% of people with epilepsy reported not noticing daytime seizures, and more than half didn’t notice them at night. Family members reported recognizing seizures and oncoming seizure activity, but they, too, were uncertain about the reliability of the signs they saw. Even when EEG readings detected seizures, only about 60% of those having the seizure knew what was happening.

Poor detection and recognition of seizure activity can lead to increased injury or death and contribute to the underdiagnosis and undertreatment of seizure disorders. The goal of seizure alert devices is to improve the overall safety and quality of life for people with epilepsy.

Drawbacks

One of the main drawbacks of seizure alert devices is that not every type can detect seizures equally. Most devices currently on the market rely on big movements to trigger an alert, so they are most useful for tonic-clonic or focal motor seizures (primary symptoms involve muscles). People with epilepsy with absent or partial seizures with minimal muscle movement or outward signs may not be a good candidate for a seizure alert device.

Other limitations of seizure alert devices include the following:

  • The reliance on a nearby caregiver or support person
  • High cost
  • Few are U.S. Food and Drug Administration- (FDA) approved

Your Body’s Seizure Alerts

If you have epilepsy or another seizure disorder, keeping a diary of things that happened or changes you noticed just before a seizure can help you recognize your body’s warning signs. In one study, around 70% of participants experienced cardiac changes like increased or decreased heart rate before a seizure.

Auras are considered the initial component of seizure activity, a predecessor to whatever altered state of consciousness may follow. One study estimated that around 64% of people with seizure disorders experience at least one type of aura symptom before a seizure begins. Aura symptoms may include:

  • Vision changes
  • A disconnect from reality
  • Strong emotions, like anxiety or fear
  • Sensitivity to smells or light
  • Repetitive movements
  • An odd taste in your mouth

The period you experience particular symptoms before a seizure is called the prodrome; tracking your symptoms during this time can help you recognize oncoming seizure activity.

Bracelets and Watches

Bracelets, watches, and other wearable devices are increasingly popular for various health applications, from tracking exercise to detecting abnormal heart rhythms.

Clinical monitors have been around for a long time, but EEG-based devices that can track your seizure activity on an outpatient basis have the potential to be uncomfortable and cumbersome.

Smartwatches that offer seizure alert or detection capabilities or add-ons are increasingly available on the commercial market. Still, studies evaluating these products have found that most lack the comprehensive tools needed to accurately detect and diagnose a range of seizure activity.

If you are interested in using a wearable device to track seizures, talk to your healthcare provider about the ideal product for your specific seizure activity. Some products have been specifically created for epilepsy detection, like the Embrace2—an FDA-approved smartwatch for detecting seizures—that can be difficult to find at retail locations.

Cameras

Cameras are another tool that can be useful in managing seizure disorders. These devices start recording when seizure activity begins and are particularly useful for tracking seizures at night or in people living alone.

Recognizing and recording seizure activity can help you and your healthcare provider develop the right treatments for your specific condition.

 

Mattress Devices and Anti-Suffocation Pillows

Because nocturnal seizures can be hard to detect and treat, devices that monitor and protect you during sleep can be especially beneficial. Special mattresses, devices that attach to a mattress, and even pillows that can help reduce the risk of suffocation during seizures are all available and recommended for people who experience seizures while sleeping.

Anti-suffocation pillows with a unique lattice-style mesh material can help you breathe better if you are sleeping with your face on a pillow when a seizure strikes. Mattresses and mattress sensors, on the other hand, can detect motion and alert you or a caregiver of an active seizure.

Why Are Nighttime Seizures So Dangerous?

Most sudden deaths from seizures happen at night, with 58–86% of cases sleeping face down. In contrast, an estimated 6% of the general population sleeps face down, leading experts to conclude that breathing problems related to suffocation during seizure activity significantly contribute to mortality.

Seizure Response Service Dogs

Animals—especially dogs—are attuned to even slight emotional or physical changes in their human companions. This makes dogs useful in providing detection and alerts for various medical conditions, including seizure detection.

A change in odor just before seizure onset is thought to trigger dogs. In one study, dogs correctly detected seizure-type odors 67–100% of the time. The report reveals that dogs have a sense of smell far more sensitive than electronic detection devices tested on the same odors. They can be trained to respond reliably with alert behaviors to help ensure their human companion’s safety.

Another study found that even pet dogs with no formal training, whose owners did not have epilepsy and had not witnessed a seizure, could consistently sense oncoming seizures and provide alerts.

Devices for Treating Seizures

In addition to detecting seizure activity, there are some products that both detect and help manage seizures.

Responsive Neurostimulation System (RNS)

The responsive neurostimulation system (RNS) monitors and detects seizure activity and responds with small bursts of stimulation designed to derail the abnormal signal that triggers seizures.

These devices are placed on the skull with wires and electrodes that sense seizure activity and deliver stimulation. RNS devices are particularly useful in treating the roughly 30% of people with seizure disorders who are resistant to anti-epileptic medications.

Vagus Nerve Stimulation (VNS)

The vagal nerve stimulator (VNS) is another device to treat medication-resistant seizures. Like the RNS, this system detects seizure activity through electrodes placed just under the skin and responds with a small impulse. However, the difference between these systems is that the RNS targets particular areas of the brain, while the VNS provides stimulation to the vagus nerve.

The vagus nerve is part of the autonomic nervous system and helps control things like your heart rate and breathing. Stimulation delivered to this area can help send signs to the brain and potentially control or impede the dangerous physical effects of seizures.

How to Choose the Right Assistive Device

There are many devices to help you detect oncoming seizures; what’s right for you will depend on your specific seizure type and frequency, your symptoms experienced during a seizure, and your goals for seizure detection.

One study from 2021 highlighted trust as the most important feature caregivers and people with seizures looked for in a seizure alert device. Fear that the device would miss seizure activity or fail to provide alerts played a significant role in which device people chose.

 

Talking to your healthcare provider about your diagnosis and seizure detection and management goals can help you find a suitable device.

Summary

Many devices on the market can detect, monitor, and even treat seizure activity. How well these devices work can depend on the type of device itself and the type of seizure you experience.

Involving your healthcare provider in selecting seizure alert devices may help you find the best fit for your specific form of epilepsy.

FREQUENTLY ASKED QUESTIONS

  • Can smartwatches like the Apple Watch detect seizures?

    Apple’s smartwatch offers an app for detecting seizures, but several other models are available from different manufacturers, too. The Embrace2 is a specific FDA-approved smartwatch that can detect seizures and provide alerts.

  • What causes seizures?

    There are many causes of seizures. Whatever the trigger—stress, hormones, or even blood sugar levels—seizures usually develop from an abnormal electrical signal resulting from the trigger.

  • Do seizure monitors work for all types of epilepsy?

    Most seizure monitors and alert systems rely on detectable movement or activity. Seizures that develop without outward physical signs, like absent seizures, can be more difficult for these monitors to detect.

 

Source: verywellhealth.com, Rachel Zimlich BSN RN, Nicholas R. Metrus MD

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