To examine epileptologist opinions and patient experiences regarding an over-the-ear real-time seizure detection device.

Our team developed BrainSD, a behind-the-ear seizure monitor that detects EEGs with four scalp contacts. BrainSD maximizes detection accuracy and usability for clinicians, and comfort and ease-of-use for patients. It was tested on 33 patients admitted to the Epilepsy Monitoring Unit (EMU) at a Level 4 Epilepsy Center. BrainSD was worn for 42 hours on average and recorded 14 seizure events.

An anonymous 14-question survey was offered to study participants at the end of the study. Subsequently, nine epileptologists were invited to a one-hour focus group to obtain opinions regarding portable seizure detection devices.

Thirty (91%) of thirty-three participants who wore BrainSD completed the post-survey. Of the thirty, seven (23.3%) strongly agreed and fifteen (50%) agreed that BrainSD was comfortable. Discomfort was expressed (16.7%) due to pressure, and the adhesive glue. Twelve (40%) strongly agreed and fourteen (46.7%) agreed that BrainSD was easy to use. Twelve (40%) patients said they would wear BrainSD continuously for over a week. Eight (26.7%) strongly agreed and ten (33.3%) agreed that BrainSD is socially acceptable to wear in public. Nine (30%) strongly agreed and ten (33.3%) agreed that they slept well while wearing BrainSD. For potential BrainSD improvements, three (10%) inquired about an auxiliary mobile application and six (20%) about seizure prediction and alerting.

Providers expressed interest in a device that detects non-motor focal seizures; uploads recordings in real-time for viewing; alerts patients before an epileptic event; and allows patients to log their events. Hesitancies with over-the-ear devices included the risk of false positive rates with the implemented 2-channel EEG.

BrainSD has the features that users desire, is acceptable and comfortable for patients, and meets epileptologists’ expectations. More features will be considered to optimize BrainSD in the future.