Home video-only recording in epilepsy care: clinical applications, technological platforms, and future directions

Home video-only recordings (HVR) of seizures are an important adjunct in diagnosing and managing epilepsy alongside video-EEG (vEEG) monitoring. HVR demonstrates high levels of accuracy, sensitivity, and specificity, making them useful for distinguishing between epileptic seizures and non-epileptic spells. HVR effectively monitors patients experiencing spells (such as movement abnormalities like tics and benign sleep myoclonus, syncope, or breath holding) that may resemble seizures. These recordings help determine seizure frequency, quantify seizure burden, and analyze seizure semiology. Additionally, HVR offers lower costs, greater accessibility, and faster diagnosis of epilepsy. They are particularly beneficial for patients in underserved areas lacking access to specialized epilepsy centers. In this review, we discuss the available epilepsy-specific platforms for home monitoring, clinical applications of HVR, benefits and limitations of HVR without EEG, technical and practical considerations, the role of artificial intelligence in HRV with the detection of seizures, and future prospects for HVR. HVR provides a practical option for epilepsy care that improves diagnostic accuracy and accessibility. With artificial intelligence integration in epilepsy diagnosis and management, HVR may see widespread adoption in clinical practice, alleviating the burden of this common condition for patients, caregivers, and healthcare providers.