Bridging the gap: Accessible Electroencephalography for Epilepsy diagnosis and management

Epilepsy affects 633,000 people in the UK and 50 million globally, with especially high impact on children and older adults. In England, epilepsy leads to 60,000 emergency admissions and costs society over £2 billion annually. Despite NICE guidelines recommending EEG within 72 hours of a suspected seizure, NHS waiting times for routine EEG are typically 6–8 weeks, contributing to misdiagnosis rates of 20–25%, increased risk of harm, and significant anxiety for families. Children are particularly vulnerable, with 80% experiencing at least one comorbidity and facing developmental and psychosocial challenges. Current diagnostic pathways rely on short, hospital-based EEGs (~30 minutes), which are often too brief to capture events, and unreliable seizure diaries. The gold standard, inpatient video EEG (vEEG), is costly, resource-intensive, and reserved for complex cases due to limited capacity. This leads to delayed or missed diagnoses, suboptimal treatment, and unnecessary admissions. Clic EEG is a novel, self-applied, wearable device enabling remote, continuous EEG monitoring for up to four days. Designed for direct-to-patient “drop-ship” deployment, it overcomes the limitations of existing systems, which require specialist staff and are unsuitable for home use. Clic EEG automatically uploads anonymised data to secure cloud storage, supporting rapid, equitable access to care, particularly for underserved or remote populations. In recent co-design studies, 100% of users (adults and children) successfully self-applied the device, reporting high comfort and superior signal quality. Over 2,000 hours of on-person recordings showed no adverse events. This project will conduct a prospective, single-centre, head-to-head feasibility study comparing Clic EEG with standard inpatient vEEG in paediatric patients at University Hospitals Bristol & Weston NHS Foundation Trust. Twelve children referred for vEEG will undergo simultaneous monitoring with both devices. The study will evaluate: Diagnostic accuracy of Clic EEG in detecting seizures and key clinical features versus vEEG. Signal quality and reliability of Clic EEG. User acceptability and ease of use for patients, carers, and clinicians. The project includes four work packages: setup and approvals, clinical feasibility study, data analysis and reporting, and ongoing patient and public involvement (PPI). The multidisciplinary team brings expertise in paediatric neurology, neurophysiology, user-centred design, and medical device development. Clic EEG is protected by patents, design rights, and trade secrets, with no known freedom-to-operate issues. The commercialisation plan targets NHS EEG units and specialist epilepsy centres, with potential for global expansion. Anticipated impact includes reduced diagnostic delays, improved seizure control, fewer emergency admissions, and better developmental outcomes for children. For the NHS, this translates into cost savings and a scalable, equitable solution aligned with NICE guidelines. Connect funding is essential to bridge the gap between proof-of-concept and large-scale clinical validation. Evidence generated will support a future NIHR i4i Product Development Award, regulatory submissions, and NHS adoption. Ultimately, Clic EEG aims to transform epilepsy diagnosis and management, delivering measurable benefits for patients, families, clinicians, and the health system.