230 days of ultra long‐term subcutaneous EEG : seizure cycle analysis and comparison to patient diary

© 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.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 recorded seizures (Cohen's kappa 0.664), although multiple clustered seizures remained undocumented. Circular statistics identified significant sqEEG seizure cycles at circadian (24-hour) and multidien (5-day) timescales. Electrographic seizure monitoring and analysis of long-term seizure cycles are possible with this neurophysiological tool.This work was supported by the Epilepsy Foundation’s Epilepsy Innovation Institute My Seizure Gauge Project. MPR is supported by the NIHR Biomedical Research Centre; the MRC Centre for Neurodevelopmental Disorders (MR/N026063/1); the EPSRC Centre for Predictive Modelling in Healthcare (EP/N014391/1); the RADAR‐CNS project (www.radar‐cns.org, grant agreement 115902).info:eu-repo/semantics/publishedVersio