There is a group of patients for which epilepsy remains intractable. Despite the arrival of new treatment options, seizures fail to come under full control for some patients. These epilepsies are sometimes also called uncontrolled or refractory.
For some of the patients with intractable epilepsy, seizure events can be prolonged – thus lasting longer than a few minutes – or they can even be non self-terminating. Thus seizure events can turn into situations of status epilepticus, which need to be terminated by medication.
Very long seizure events are dangerous situations. There is the risk that a few of these episodes may result in motor, intellectual and behavioral regressions. Unfortunately, prolonged seizures are also associated with an increased risk of death.
To manage these situations, intervention is required. Emergency medication is needed to terminate the seizures. The earlier the seizures are detected and medication is provided, the easier it is to stop the events and the lower is the risk of lasting damage.
It is not a surprise that these situations put significant pressures not only on the patients but also on the caregivers. As seizures can occur at any time of the day, parents have to be constantly alert and need to provide around-the-clock care to their children. In particular, night-time events are a great concern. A prolonged seizure while the parents are asleep is a much-feared scenario.
Automated seizure detection systems (for example smart watches, sensor mattresses and cameras with motion detection recognition) monitor body movements and help to reduce risks for many patients. However these systems do not work for those patients where seizure signs are subtle and motor involvement remains below threshold values.
To manage these situations parents are often sleeping in their children’s room or have a baby monitor active on their bed-side. Aiming at a light sleep, they hope to wake up from a seizure event or have their sleep regular interrupted to check on their kid. Some parents also take night shifts but nevertheless seizure events may be missed occasionally.