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Minimum clinical utility standards for wearable seizure detectors: a simulation...

Goldenholz, Daniel M.; Karoly, Philippa J.; Viana, Pedro; Nurse, Ewan; Loddenkemper, Tobias; Schulze‐Bonhage, Andreas; Vieluf, Solveig; Bruno, Elisa

Objective: Epilepsy management employs self-reported seizure diaries, despite evidence of seizure underreporting. Wearable and implantable seizure detection devices are now becoming more widely available. There are no clear guidelines about what levels of accuracy are sufficient. This study aimed to simulate clinical use cases and identify the necessary level of accuracy for each. Methods: Using a realistic sei...


Feasibility and acceptability of an ultra-long-term at-home EEG monitoring syst...

Biondi, Andrea; Simblett, Sara K.; Viana, Pedro; Laiou, Petroula; Fiori, Anna M.G.; Nurse, Ewan; Schreuder, Martijn; Pal, Deb K.; Richardson, Mark P.

Background: Recent technological advancements offer new ways to monitor and manage epilepsy. The adoption of these devices in routine clinical practice will strongly depend on patient acceptability and usability, with their perspectives being crucial. Previous studies provided feedback from patients, but few explored the experience of them using independently multiple devices independently at home. Purpose: The...



Kaliningrad and the Lithuanian “geopolitical code"

Fernandes, Sandra; Viana, Pedro

The paper analyses the evolving role of Kaliningrad in shaping Lithuania‟s security perceptions vis-à-vis Russia. Applying the framework of the “geopolitical code” designed by Flint, the authors question whether the exclave-enclave nexus in the Kaliningrad region ‒ after the European Union (EU) and the Atlantic Alliance (NATO) enlargements ‒ has been a relevant change in context that has affected Vilnius' secur...


Seizure forecasting using minimally invasive, ultra‐long‐term subcutaneous elec...

Viana, Pedro; Pal Attia, Tal; Nasseri, Mona; Duun‐Henriksen, Jonas; Biondi, Andrea; Winston, Joel S.; Martins, Isabel Pavão; Nurse, Ewan S.

Objective: One of the most disabling aspects of living with chronic epilepsy is the unpredictability of seizures. Cumulative research in the past decades has advanced our understanding of the dynamics of seizure risk. Technological advances have recently made it possible to record pertinent biological signals, including electroencephalogram (EEG), continuously. We aimed to assess whether patient-specific seizur...


Non-invasive wearable seizure detection using long–short-term memory networks w...

Nasseri, Mona; Pal Attia, Tal; Joseph, Boney; Gregg, Nicholas M.; Nurse, Ewan S.; Viana, Pedro; Schulze-Bonhage, Andreas; Dümpelmann, Matthias

Objective. The detection of seizures using wearable devices would improve epilepsy management, but reliable detection of seizures in an ambulatory environment remains challenging, and current studies lack concurrent validation of seizures using electroencephalography (EEG) data. Approach. An adaptively trained long–short-term memory deep neural network was developed and trained using a modest number of seizure ...


Remote and long-term self-monitoring of electroencephalographic and noninvasive...

Biondi, Andrea; Laiou, Petroula; Bruno, Elisa; Viana, Pedro; Schreuder, Martijn; Hart, William; Nurse, Ewan; Pal, Deb K.; Richardson, Mark P.

Background: Epileptic seizures are spontaneous events that severely affect the lives of patients due to their recurrence and unpredictability. The integration of new wearable and mobile technologies to collect electroencephalographic (EEG) and extracerebral signals in a portable system might be the solution to prospectively identify times of seizure occurrence or propensity. The performances of several seizure ...


Seizure diaries and forecasting with wearables: epilepsy monitoring outside the...

Brinkmann, Benjamin H.; Karoly, Philippa J.; Nurse, Ewan S.; Dumanis, Sonya B.; Nasseri, Mona; Viana, Pedro; Schulze-Bonhage, Andreas

It is a major challenge in clinical epilepsy to diagnose and treat a disease characterized by infrequent seizures based on patient or caregiver reports and limited duration clinical testing. The poor reliability of self-reported seizure diaries for many people with epilepsy is well-established, but these records remain necessary in clinical care and therapeutic studies. A number of wearable devices have emerged...


230 days of ultra long‐term subcutaneous EEG : seizure cycle analysis and compa...

Viana, Pedro; Duun‐Henriksen, Jonas; Glasstëter, Martin; Dümpelmann, Matthias; Nurse, Ewan S.; Martins, Isabel Pavão; Dumanis, Sonya B.

We describe the longest period of subcutaneous EEG (sqEEG) monitoring to date, in a 35-year-old female with refractory epilepsy. Over 230 days, 4791/5520 h of sqEEG were recorded (86%, mean 20.8 [IQR 3.9] hours/day). Using an electronic diary, the patient reported 22 seizures, while automatically-assisted visual sqEEG review detected 32 seizures. There was substantial agreement between days of reported and reco...


Short-lasting retroorbital pain attacks as a form of ictal epileptic headache: ...

Viana, Pedro; Hasegawa, Harumoto; Jarosz, Josef; Siddiqui, Ata; Selway, Richard P.; Mullatti, Nandini

Background and objectives: Ictal epileptic headache is a rare form of painful seizure, habitually consisting of migrainous or tension-type headache. We describe a case of a patient with short-lasting, severe retroorbital pain attacks caused by frontal lobe epilepsy. Case report: A 25-year-old male patient presented with recurrent attacks of paroxysmal, short-lasting, excruciating left periorbital and facial pai...


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