title: Non-EEG seizure detection systems and potential SUDEP prevention: State of the art: Review and update.
abstract: OBJECTIVE
  Detection of, and alarming for epileptic seizures is increasingly demanded and researched. Our previous review article provided an overview of non-invasive, non-EEG (electro-encephalography) body signals that can be measured, along with corresponding methods, state of the art research, and commercially available systems. Three years later, many more studies and devices have emerged. Moreover, the boom of smart phones and tablets created a new market for seizure detection applications.
  
  
  METHODS
  We performed a thorough literature review and had contact with manufacturers of commercially available devices.
  
  
  RESULTS
  This review article gives an updated overview of body signals and methods for seizure detection, international research and (commercially) available systems and applications. Reported results of non-EEG based detection devices vary between 2.2% and 100% sensitivity and between 0 and 3.23 false detections per hour compared to the gold standard video-EEG, for seizures ranging from generalized to convulsive or non-convulsive focal seizures with or without loss of consciousness. It is particularly interesting to include monitoring of autonomic dysfunction, as this may be an important pathophysiological mechanism of SUDEP (sudden unexpected death in epilepsy), and of movement, as many seizures have a motor component.
  
  
  CONCLUSIONS
  Comparison of research results is difficult as studies focus on different seizure types, timing (night versus day) and patients (adult versus pediatric patients). Nevertheless, we are convinced that the most effective seizure detection systems are multimodal, combining for example detection methods for movement and heart rate, and that devices should especially take into account the user's seizure types and personal preferences.
authors: Dept. of Neurology-Pediatric Neurology, Antwerp University Hospital-University of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium. Electronic address: anouk.vandevel@uza.be.
authors: Anouk
authors: A
authors: Van de Vel
authors: Mobilab, Thomas More Kempen, Kleinhoefstraat 4, B-2440 Geel, Belgium. Electronic address: kris.cuppens@thomasmore.be.
authors: Kris
authors: K
authors: Cuppens
authors: Mobilab, Thomas More Kempen, Kleinhoefstraat 4, B-2440 Geel, Belgium. Electronic address: bert.bonroy@thomasmore.be.
authors: Bert
authors: B
authors: Bonroy
authors: KU Leuven, Dept. of Electrical Engineering-ESAT, STADIUS, Kasteelpark Arenberg 10 Postbus 2446, B-3001 Leuven, Belgium; iMinds Medical Information Technologies, Leuven, Belgium. Electronic address: mili.milosevic@gmail.com.
authors: Milica
authors: M
authors: Milosevic
authors: Dept. of Pediatric Neurology, University Hospitals Leuven-Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: katrien.jansen@uzleuven.be.
authors: Katrien
authors: K
authors: Jansen
authors: KU Leuven, Dept. of Electrical Engineering-ESAT, STADIUS, Kasteelpark Arenberg 10 Postbus 2446, B-3001 Leuven, Belgium; iMinds Medical Information Technologies, Leuven, Belgium. Electronic address: Sabine.VanHuffel@esat.kuleuven.be.
authors: Sabine
authors: S
authors: Van Huffel
authors: KU Leuven, Dept. of Electrical Engineering-ESAT, STADIUS, Kasteelpark Arenberg 10 Postbus 2446, B-3001 Leuven, Belgium; iMinds Medical Information Technologies, Leuven, Belgium. Electronic address: bart.vanrumste@esat.kuleuven.be.
authors: Bart
authors: B
authors: Vanrumste
authors: Dept. of Neurology, Antwerp University Hospital-University of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium. Electronic address: patrick.cras@uza.be.
authors: Patrick
authors: P
authors: Cras
authors: Dept. of Pediatric Neurology, University Hospitals Leuven-Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; Rehabilitation Centre for Children and Youth Pulderbos, Reebergenlaan 4, B-2242 Zandhoven, Belgium. Electronic address: lieven.lagae@uzleuven.be.
authors: Lieven
authors: L
authors: Lagae
authors: Dept. of Neurology-Pediatric Neurology, Antwerp University Hospital-University of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium; Rehabilitation Centre for Children and Youth Pulderbos, Reebergenlaan 4, B-2242 Zandhoven, Belgium. Electronic address: berten.ceulemans@uza.be.
authors: Berten
authors: B
authors: Ceulemans
mesh_terms: D003645:Death, Sudden / Q000209:etiology* / Q000517:prevention & control*; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D006801:Humans
keywords: Alarm system; Epilepsy; Non-EEG based seizure detection; SUDEP; Sudden unexpected death