Feasibility of automated warning in subjects with localization-related epilepsies

Automated seizure detection ushers the prospect for issuance of warning, but to benefit from it, patients must be responsive when warnings are issued. By use of a complex reaction time test triggered by a seizure detection algorithm, the latency to impairment of responsiveness was measured during seizure versus interictal conditions in 14 patients undergoing surgical evaluation with intracranial electrodes. Mean latency to impairment of responsiveness from electrographic onset was 27.1, 42.8, or 56.1 seconds depending on the stringency of the defining criterion. Mean, SD, and distributions of compliance and percentage of correct responses did not significantly differ between seizure and interictal tests. If reproduced in studies performed under more realistic conditions, the latency to impairment of responsiveness justifies the development of a warning device to allow patients to perform activities precluded by seizures and decrease the risk of injury. If endowed with automated therapy delivery, said device would advance epilepsy management cost-effectively.