Therapeutics
Background
Making an accurate diagnosis of epilepsy depends on being able to reliably detect seizures and abnormal brain activity. However, this is often challenging. Some seizures are subtle, brief, or occur during sleep, meaning they may never be noticed or reported. As a result, seizure diaries and short EEG recordings can provide an incomplete or misleading picture of what is really happening in the brain.
Although inpatient video‑EEG monitoring is the most reliable diagnostic tool available, it requires hospital admission and is typically limited to a few days of recording. This makes it difficult to capture seizure patterns that occur unpredictably over weeks or months. For people with drug‑resistant epilepsy, these limitations can delay diagnosis, complicate treatment decisions, and leave important questions unanswered.
Research
A team of researchers, led by FutureNeuro Principal Investigator Professor Norman Delanty, investigated whether a minimally invasive, subcutaneous EEG (sqEEG) device could provide accurate, continuous brain monitoring over much longer periods in people with drug‑refractory idiopathic generalized epilepsy.
In this prospective study, nine patients were implanted with a small EEG electrode placed just beneath the scalp and monitored continuously at home for up to 12 weeks using a CE‑marked sqEEG system. Recordings from the device were compared directly with inpatient video‑EEG recordings, which served as the diagnostic gold standard.
The study showed that ultra long‑term sqEEG detected all generalized convulsive seizures recorded during hospital monitoring, as well as around 90% of clinically significant non‑convulsive seizure activity. EEG signal quality was comparable to standard scalp EEG, and the device remained stable over months of use. Importantly, patients reported high satisfaction, good comfort, and ease of integration into everyday life. Ongoing outpatient monitoring also uncovered seizures that had not been recognised through self‑reporting alone.
Potential Impact
This study provides the first evidence that ultra long‑term, minimally invasive EEG monitoring can reliably detect both convulsive and non‑convulsive seizures in people with drug‑resistant idiopathic generalized epilepsy, outside of the hospital setting.
By capturing objective brain activity continuously over weeks and months—rather than days—this approach has the potential to transform how seizure burden is assessed, support more precise diagnostic and treatment decisions, reduce reliance on seizure diaries, and identify seizures that might otherwise go unnoticed.
These findings laid the groundwork for subsequent large‑scale clinical trials now underway, positioning long‑term subcutaneous EEG monitoring as an important step toward more personalised, data‑driven epilepsy diagnosis and care.
Read the full publication here
