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Epilepsy affects millions worldwide, with 40% of patients experiencing uncontrolled seizures despite medication. Comprehensive epilepsy centers recommend continuous video-electroencephalography monitoring to define seizure type and distinguish mimickers. This process, however, is resource-intensive, with lengthy hospital stays. The investigators' recent study identified a heightened association between arousals and epileptic activity in drug-resistant focal epilepsy patients. Building on these findings, the investigators aim to explore whether disrupting sleep with an alarm system triggers earlier occurrence of seizures, potentially offering insights to reduce hospital stay durations in epilepsy monitoring units.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Alarm | Experimental | Patients in the alarm group will have an alarm system placed in their room, scheduled to sound at 4 timepoints during the night (specific timepoints adjusted based on patient's preferred bed times). This intervention will stop when the clinical team has collected sufficient seizures for clinical decision making. |
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| Control | No Intervention | Patients in the control group will have an alarm system placed in their room, but the alarm system will not sound during any of the nights during their EMU admission. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Alarm system | Device | Generic alarm system programmed to sound during the night to try to induce arousals from sleep. |
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| Measure | Description | Time Frame |
|---|---|---|
| Seizure frequency during EMU (epilepsy monitoring unit) stay | Average number of seizures per day, recorded daily during the patient's EMU stay. Measured for all groups of patients. | 1 month after the EMU stay (up to 9 weeks) |
| Duration of EMU (epilepsy monitoring unit) admission | Overall duration (in days) of the EMU admission. Measured for all groups of patients. | 1 month after the EMU stay (up to 9 weeks) |
| Average interictal spike rates | Average number of spike rates, taken from a random segment for each day and night. Measured for all groups of patients. | 1 month after the EMU stay (up to 9 weeks) |
| Change in sleep quality | As determined by changes in Pittsburgh Sleep Quality Index scores. A higher score indicates increased sleep disturbances. | Baseline (Day 1), last day of EMU stay (up to 5 weeks), 1 month after the EMU stay (up to 9 weeks) |
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Inclusion Criteria:
Exclusion Criteria:
- Multiple seizures a day based on pre-admission seizure diary
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Birgit Frauscher, MD PD | Contact | 9196139386 | birgit.frauscher@duke.edu | |
| Mays Khweileh, MD | Contact | mays.khweileh@duke.edu |
| Name | Affiliation | Role |
|---|---|---|
| Birgit Frauscher, MD PD | Duke University | Principal Investigator |
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| ID | Term |
|---|---|
| D000069279 | Drug Resistant Epilepsy |
| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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During their epilepsy monitoring unit (EMU) admission, patients will be divided into either the alarm group or the control group. Patients in the alarm group will have an alarm system placed in their room, scheduled to sound at several timepoints during the night. This intervention will be conducted throughout the whole EMU admission. Patients in the control group will have an alarm system placed in their room, but the alarm system will not sound during any of the nights during their EMU admission.
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This is a single blind study and patients will not know which group they are in.