David Burdette, MD, has a “very fitness-oriented patient” who goes to college on the West Coast. The patient also has epilepsy and wears a Fitbit.
One morning earlier this year, the patient woke up with a sore tongue and felt aching and exhaustion in his muscles.
“So he uploads his Fitbit data, looks at the computer, and at about 2:30 a.m., he had had prominent motor activity like he had done a massive workout,” said Dr. Burdette, section chief of epilepsy and clinical neuropsychology for Spectrum Health Medical Group.
“Based on that data, we assumed he had a generalized seizure, and adjusted his medicine,” the doctor said.
The patient hasn’t had a seizure since.
About 50 million smartwatches, fitness trackers and other wearable technology devices were shipped in 2015, and that number is expected to increase to 125 million by 2019. As technologies have skyrocketed in popularity, an awareness of their ability to help epilepsy patients has also increased.
Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures. More than 2 million Americans suffer from epilepsy and the majority have their disorder well-controlled by medication, Dr. Burdette said.
Many of these patients will remain seizure-free for more than five years, he said.
But the other one-third of patients — and even those on effective medications — can still experience tonic-clonic seizures, which involve loss of consciousness, stiffened muscles, writhing and convulsions.
Tonic-clonic seizures are dangerous. The sudden unexpected death of epilepsy patients, called SUDEP, occurs in about 1 in 1,100 adults each year and 1 in 4,500 children, according to the Epilepsy Foundation.
Wearable technologies and seizure-alert devices offer two advantages to patients.
First, they help detect seizures. The only certain way to detect a seizure, Dr. Burdette said, is to use an electroencephalogram, better known as an EEG, which measures brain waves. But wearable technologies can measure heart rates, acceleration speeds, skin temperature, sweating rates and the tilting or rotating of the body, which all can be “surrogate markers” for a seizure, he said.
Often patients lose large chunks of time — another “surrogate marker” for a seizure — or they don’t realize they had a seizure. These technologies can help track those incidents, too.
“With heart-rate monitors and accelerometers, you can look at surrogate markers and try to ascertain, ‘Did this person have a seizure or not?’” Dr. Burdette said. “If you just had this in your sleep, this two-minute massive workout that shows up in the data, you can say with a pretty high degree of certainty that you had a seizure.”
The other major advantage of these wearable technologies is that the devices can notify loved ones, caregivers or emergency services if a patient is having a seizure.
The Embrace watch, one of many wearables with varying levels of technology, uses Bluetooth to send text or phone-call alerts to loved ones or caregivers when surrogate markers indicate a seizure is occurring.
These advancements can save lives, Dr. Burdette said.
And more breakthroughs are on the way.
Dr. Burdette said the “Holy Grail” of seizure-alert devices would be ones that can identify predictors.
“Let’s say this person, every time their heart rate increases by 50 percent over the span of five seconds, and they have an increase in sweating on the left wrist, that within another one to two minutes they’re going to have a seizure,” Dr. Burdette said. “Then you have a marker. Then you could potentially do something to make them more safe as they have a seizure. Or you could do some type of intervention and prevent the seizure.
“The earlier you can detect, the more intervention is possible. Maybe we fit you with a detecting device, an Embrace or a Fitbit or a Garmin watch, and interface that via BlueTooth with something that squirts (a liquid drug) into your nose, avoiding the seizures. Now we’re able to intervene in advance.
“We’re approaching it, but we’re not there yet,” he said.
Dr. Burdette said he hoped a “practicable” device would be on the market in five to 10 years. In the meantime, he recommends epilepsy patients — especially the one-third with frequent seizures — discuss current wearable technologies with their doctors.