The Challenging Path to Developing a Mobile Health Device for Epilepsy: The Current Landscape and Where We Go From Here

Seizure detection, and more recently seizure forecasting, represent important avenues of clinical development in epilepsy, promoted by progress in wearable devices and mobile health (mHealth), which might help optimizing seizure control and prevention of seizure-related mortality and morbidity in persons with epilepsy. Yet, very long-term continuous monitoring of seizure-sensitive biosignals in the ambulatory setting presents a number of challenges. We herein provide an overview of these challenges and current technological landscape of mHealth devices for seizure detection. Specifically, we display, which types of sensor modalities and analytical methods are available, and give insight into current clinical practice guidelines, main outcomes of clinical validation studies, and discuss how to evaluate device performance at point-of-care facilities. We then address pitfalls which may arise in patient compliance and the need to design solutions adapted to user experience.