{
  "id": "AIBD-0297",
  "title": "Nelli audio-video AI seizure monitor records 247 nocturnal events missed by carers among 15 people with intellectual disability in Cornwall; Danish validation detected all 11 tonic-clonic seizures",
  "summary": "Cornwall NHS evaluation (15 people who could not tolerate EEG): Nelli flagged 707 possible seizure events, 247 unheard or unrecognised by carers; Danish phase-3 validation sensitivity 93.7%.",
  "date_observed": "2023-04-23",
  "date_basis": "unassessed",
  "date_precision": "unassessed",
  "benefit_status": null,
  "source_collection": null,
  "source_entry": null,
  "account": "Nelli, made by Neuro Event Labs of Tampere, Finland, is a camera-and-microphone unit. Computer vision and what its validators call an artificial-intelligence-based algorithm flag nocturnal motor seizures from its signals. A phase-3 validation at the Danish Epilepsy Center and Aarhus University Hospital had 191 participants, recruited 14 October 2019 to 18 June 2021. It had 4,183 night-time hours, analyzed in real time against video electroencephalography (EEG). Armand Larsen, Beniczky and colleagues, with two Neuro Event Labs co-authors, reported 93.7% sensitivity for major motor seizures (Brain and Behavior, 8 August 2022). All 11 tonic-clonic and four of five hypermotor seizures were detected. False detections were 0.16 per hour, device deficiency 10.5% of the time, and sensitivity for minor motor seizures only 8.3%. Lennard, Shankar and colleagues of the National Health Service (NHS) trust Cornwall Partnership NHS Foundation Trust then evaluated Nelli in the community. The 15 participants had intellectual disability and drug-resistant epilepsy and could not tolerate routine or ambulatory EEG. The report appeared in Epilepsy & Behavior Reports on 23 April 2023. The source gives no study dates. Nelli recorded 707 possible seizure events in 14 people, 247 of them unheard or unrecognized by carers. One person had half of possible events missed by night staff. Carers logged 165 “restless” or “seizure behavior” episodes that Nelli did not deem seizures. Acceptability was 93%. The authors conclude Nelli “allowed for improved communication and care planning”. A single-center feasibility study in Dravet and Lennox-Gastaut syndromes (Wilms et al., Epilepsia, online 9 October 2025; abstract read) ran four weeks of home monitoring. It detected 368 seizures with 97.8% accuracy, while only 26.1% were logged in diaries. No individual's changed outcome is documented in any cited source.",
  "category": "general benefit",
  "unexpected": false,
  "purpose": "Built to detect nocturnal major motor seizures from audio-video so that staff can intervene and clinicians can see events patients cannot report. The unrecognized events it surfaced are that purpose.",
  "system": "Nelli audio-video seizure monitoring system (computer vision and AI-based event detection)",
  "model_version": null,
  "developer": "Neuro Event Labs, Tampere, Finland",
  "deployer": "Cornwall Partnership NHS Foundation Trust (community evaluation); Danish Epilepsy Center, Dianalund, and Aarhus University Hospital (validation)",
  "location": "Cornwall, United Kingdom; Dianalund and Aarhus, Denmark",
  "domain": "Healthcare (epilepsy; nocturnal seizure monitoring)",
  "segment": "Residential and institutional seizure monitoring for people with intellectual disability",
  "benefit_type": "Improved Physical Health",
  "taxonomy_note": "The gain is seizure information for people with intellectual disability who could not tolerate EEG, which also reads as accessibility.",
  "registry_ids": {},
  "ratings": [
    {
      "group": "personal",
      "depth": null,
      "reason": "Carers reported peace of mind (13 of 14). Clinicians gained event counts for people who cannot report seizures. No cited source documents a treatment change or injury avoided for a named individual."
    },
    {
      "group": "organizational",
      "depth": null,
      "reason": "The Cornwall authors describe improved care planning and carer training. No measured change in staffing, response times or incidents is reported."
    }
  ],
  "ai_role": {
    "status": "assessed",
    "statement": "The system flagged motor events that night staff and carers had not noticed (247 of 707 in Cornwall). In the Danish validation it detected every tonic-clonic seizure in real time. Clinicians still reviewed sampled clips to confirm events. Sensitivity for minor motor seizures was 8.3%. One Cornwall participant's unit was removed to prevent injury and equipment damage. The validation paper is co-authored by two vendor employees. The Cornwall evaluation is independent of the maker."
  },
  "evidence": [
    {
      "kind": "peer-reviewed study",
      "citation": "Lennard S, Newman R, McLean B, Jory C, Cox D, Young C, Corson E, Shankar R (2023). Improving nocturnal event monitoring in people with intellectual disability in community using an artificial intelligence camera. Epilepsy & Behavior Reports 22:100603 (PMC10160340).",
      "title": "Improving nocturnal event monitoring in people with intellectual disability in community using an artificial intelligence camera",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10160340/",
      "date": "2023-04-23",
      "written_by": "deployer",
      "quote": "Nelli recorded 707 possible seizure events across the 14 PwID of which 247 were either not heard or not recognised by carers."
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Lennard et al. (2023), Epilepsy Behav Rep 22:100603, abstract.",
      "title": "Improving nocturnal event monitoring in people with intellectual disability in community using an artificial intelligence camera",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10160340/",
      "date": "2023-04-23",
      "written_by": "deployer",
      "quote": "Nelli allowed for improved communication and care planning in a hitherto difficult to investigate population."
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Armand Larsen S, Terney D, Østerkjerhuus T, Vinding Merinder T, Annala K, Knight A, Beniczky S (2022). Automated detection of nocturnal motor seizures using an audio-video system. Brain and Behavior 12(9):e2737 (PMC9480955). Annala and Knight are Neuro Event Labs employees and shareholders.",
      "title": "Automated detection of nocturnal motor seizures using an audio-video system",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9480955/",
      "date": "2022-08-08",
      "written_by": "makers",
      "quote": "The system detected all 11 TCS and four out of five (80%) hypermotor seizures."
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Armand Larsen et al. (2022), Brain Behav 12(9):e2737, methods.",
      "title": "Automated detection of nocturnal motor seizures using an audio-video system",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9480955/",
      "date": "2022-08-08",
      "written_by": "makers",
      "quote": "we assessed the performance of automated detection of nocturnal motor seizures using audio‐video streaming, computer vision and an artificial intelligence‐based algorithm (Nelli)"
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Wilms LK, Lossius MI, Annala K, Abdel-Khalik J, Fanter L, Elomaa K, Peltola J (2025). Seizure classification using a multimodal seizure monitoring system (Nelli) in Dravet and Lennox-Gastaut syndromes: A non-randomized, single-center feasibility study. Epilepsia, online 9 October 2025; doi:10.1111/epi.18640 (PMID 41066202; PMC12893256). Neuro Event Labs co-authors.",
      "title": "Seizure classification using a multimodal seizure monitoring system (Nelli) in Dravet and Lennox-Gastaut syndromes: A non-randomized, single-center feasibility study",
      "url": "https://europepmc.org/article/MED/41066202",
      "date": "2025-10-09",
      "written_by": "makers",
      "quote": null
    }
  ],
  "replication": {
    "produced_by": [
      "A camera and microphone unit streaming to a server where computer-vision and AI algorithms flag motor events",
      "Night-time use for people with suspected nocturnal seizures who could not tolerate EEG, with family or carer consent",
      "Clinician review of flagged clips (the Cornwall paper says 8–9% of the recording is sampled by an epilepsy expert)"
    ],
    "must_hold": [
      "Device deficiency kept low (10.5% of monitored time in the Danish validation)",
      "Staff available at night to act on alarms, the setting the validators say the system is suited to",
      "The target is major motor seizures; minor motor seizures were detected at 8.3% sensitivity"
    ],
    "echoes": [
      {
        "date": "2025-10-09",
        "setting": "Single-center feasibility study, 20 patients with Dravet or Lennox-Gastaut syndrome, four weeks of home monitoring in bed, August 2023 to March 2024",
        "model_version": null,
        "outcome": "recurred",
        "source": "Wilms LK, Lossius MI, Annala K, Abdel-Khalik J, Fanter L, Elomaa K, Peltola J (2026) Epilepsia 67(1):164-174, doi:10.1111/epi.18640 (abstract: 368 seizures detected with 97.8% accuracy; 'only 26.1% of the seizures were documented' in diaries; vendor co-authors)"
      }
    ]
  },
  "paired_incident": null,
  "headline": "Nelli flags 247 nocturnal seizure events missed by carers",
  "metric": "Nelli flagged 707 possible seizure events, 247 unheard or unrecognised by carers",
  "comparator": {
    "against": "carers' hearing or recognition of night-time events in the same people",
    "before": "247 were not heard or recognised by carers",
    "after": "Nelli recorded 707 possible seizure events across the study cohort",
    "basis": "measured",
    "quote": "Nelli recorded 707 possible seizure events across the study cohort of which 247 were not heard or recognised by carers. Carers recorded 165 episodes of ‘restless’ or “seizure behaviour” which the Nelli did not deem to be seizures.",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10160340/"
  },
  "later": {
    "status": "persisted",
    "date": "2025-10-09",
    "note": "A later single-center feasibility study in Dravet and Lennox-Gastaut syndromes, with vendor co-authors, reported that Nelli detected 368 seizures at 97.8% accuracy over four weeks of home monitoring while diaries documented only 26.1% of seizures.",
    "quote": "Nelli demonstrated high sensitivity and classification accuracy for detecting and categorizing seizures in bed in patients with DS and LGS, outperforming seizure diaries and providing a reliable tool for seizure monitoring in home settings.",
    "url": "https://europepmc.org/article/MED/41066202"
  },
  "value": null,
  "developer_country": "Finland",
  "deployer_country": "United Kingdom",
  "unrated_because": null,
  "brief_notes": null,
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    {
      "date": "2026-10-20",
      "change": "Record drafted from the cited sources.",
      "source": null,
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.",
      "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Added what the benefit is measured against, what happened since from the cited sources.",
      "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10160340/; https://europepmc.org/article/MED/41066202",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Country of the developer and the deployer added from the organization's own site or a registry.",
      "source": "https://neuroeventlabs.com/contact/; https://directory.spineservices.nhs.uk/ORD/2-0-0/organisations/RJ8",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
      "source": null,
      "editor": "AIBD"
    }
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            "account": "Nelli, made by Neuro Event Labs of Tampere, Finland, is a camera-and-microphone unit. Computer vision and what its validators call an artificial-intelligence-based algorithm flag nocturnal motor seizures from its signals. A phase-3 validation at the Danish Epilepsy Center and Aarhus University Hospital had 191 participants, recruited 14 October 2019 to 18 June 2021. It had 4,183 night-time hours, analyzed in real time against video electroencephalography (EEG). Armand Larsen, Beniczky and colleagues, with two Neuro Event Labs co-authors, reported 93.7% sensitivity for major motor seizures (Brain and Behavior, 8 August 2022). All 11 tonic-clonic and four of five hypermotor seizures were detected. False detections were 0.16 per hour, device deficiency 10.5% of the time, and sensitivity for minor motor seizures only 8.3%. Lennard, Shankar and colleagues of the National Health Service (NHS) trust Cornwall Partnership NHS Foundation Trust then evaluated Nelli in the community. The 15 participants had intellectual disability and drug-resistant epilepsy and could not tolerate routine or ambulatory EEG. The report appeared in Epilepsy & Behavior Reports on 23 April 2023. The source gives no study dates. Nelli recorded 707 possible seizure events in 14 people, 247 of them unheard or unrecognized by carers. One person had half of possible events missed by night staff. Carers logged 165 “restless” or “seizure behavior” episodes that Nelli did not deem seizures. Acceptability was 93%. The authors conclude Nelli “allowed for improved communication and care planning”. A single-center feasibility study in Dravet and Lennox-Gastaut syndromes (Wilms et al., Epilepsia, online 9 October 2025; abstract read) ran four weeks of home monitoring. It detected 368 seizures with 97.8% accuracy, while only 26.1% were logged in diaries. No individual's changed outcome is documented in any cited source.",
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        "review_state": "record_mapped",
        "coverage": "partial"
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        "state": "not_assessed",
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      },
      "strategic_assessments[]": {
        "state": "not_assessed",
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        "family": "strategic assessments"
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        "state": "value_present",
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          "kind": "record_fields",
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            "summary": "Cornwall NHS evaluation (15 people who could not tolerate EEG): Nelli flagged 707 possible seizure events, 247 unheard or unrecognised by carers; Danish phase-3 validation sensitivity 93.7%.",
            "account": "Nelli, made by Neuro Event Labs of Tampere, Finland, is a camera-and-microphone unit. Computer vision and what its validators call an artificial-intelligence-based algorithm flag nocturnal motor seizures from its signals. A phase-3 validation at the Danish Epilepsy Center and Aarhus University Hospital had 191 participants, recruited 14 October 2019 to 18 June 2021. It had 4,183 night-time hours, analyzed in real time against video electroencephalography (EEG). Armand Larsen, Beniczky and colleagues, with two Neuro Event Labs co-authors, reported 93.7% sensitivity for major motor seizures (Brain and Behavior, 8 August 2022). All 11 tonic-clonic and four of five hypermotor seizures were detected. False detections were 0.16 per hour, device deficiency 10.5% of the time, and sensitivity for minor motor seizures only 8.3%. Lennard, Shankar and colleagues of the National Health Service (NHS) trust Cornwall Partnership NHS Foundation Trust then evaluated Nelli in the community. The 15 participants had intellectual disability and drug-resistant epilepsy and could not tolerate routine or ambulatory EEG. The report appeared in Epilepsy & Behavior Reports on 23 April 2023. The source gives no study dates. Nelli recorded 707 possible seizure events in 14 people, 247 of them unheard or unrecognized by carers. One person had half of possible events missed by night staff. Carers logged 165 “restless” or “seizure behavior” episodes that Nelli did not deem seizures. Acceptability was 93%. The authors conclude Nelli “allowed for improved communication and care planning”. A single-center feasibility study in Dravet and Lennox-Gastaut syndromes (Wilms et al., Epilepsia, online 9 October 2025; abstract read) ran four weeks of home monitoring. It detected 368 seizures with 97.8% accuracy, while only 26.1% were logged in diaries. No individual's changed outcome is documented in any cited source."
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          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
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          "source_refs": []
        },
        "review_state": "record_mapped",
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      },
      "systems[].autonomy_permissions": {
        "state": "not_assessed",
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        "coverage": "partial"
      },
      "systems[].component_role": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].deployment_configuration": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].inputs_outputs": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].model_name": {
        "state": "not_assessed",
        "review_state": "not_assessed",
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      },
      "systems[].model_version": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].product_name": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "system": "Nelli audio-video seizure monitoring system (computer vision and AI-based event detection)"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
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            "system"
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        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
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        "state": "value_present",
        "value": {
          "kind": "structured",
          "data": {
            "application_developer": "Neuro Event Labs, Tampere, Finland"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Mapped from the existing case description without a new external source review.",
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            "developer"
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "taxonomy_crosswalks[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
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      "title": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "title": "Nelli audio-video AI seizure monitor records 247 nocturnal events missed by carers among 15 people with intellectual disability in Cornwall; Danish validation detected all 11 tonic-clonic seizures",
            "headline": "Nelli flags 247 nocturnal seizure events missed by carers"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "title",
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          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
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      "version": {
        "state": "value_present",
        "value": {
          "kind": "identifiers",
          "identifiers": [
            "916bef6a0a2af27bda417c248c50a5f12f401749fda46099943762426b41a002"
          ],
          "role": "SHA-256 of normalized original case data"
        },
        "provenance": {
          "kind": "curatorial",
          "basis": "Deterministic content version assigned by the local migration.",
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "complete"
      },
      "workflow": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "account": "Nelli, made by Neuro Event Labs of Tampere, Finland, is a camera-and-microphone unit. Computer vision and what its validators call an artificial-intelligence-based algorithm flag nocturnal motor seizures from its signals. A phase-3 validation at the Danish Epilepsy Center and Aarhus University Hospital had 191 participants, recruited 14 October 2019 to 18 June 2021. It had 4,183 night-time hours, analyzed in real time against video electroencephalography (EEG). Armand Larsen, Beniczky and colleagues, with two Neuro Event Labs co-authors, reported 93.7% sensitivity for major motor seizures (Brain and Behavior, 8 August 2022). All 11 tonic-clonic and four of five hypermotor seizures were detected. False detections were 0.16 per hour, device deficiency 10.5% of the time, and sensitivity for minor motor seizures only 8.3%. Lennard, Shankar and colleagues of the National Health Service (NHS) trust Cornwall Partnership NHS Foundation Trust then evaluated Nelli in the community. The 15 participants had intellectual disability and drug-resistant epilepsy and could not tolerate routine or ambulatory EEG. The report appeared in Epilepsy & Behavior Reports on 23 April 2023. The source gives no study dates. Nelli recorded 707 possible seizure events in 14 people, 247 of them unheard or unrecognized by carers. One person had half of possible events missed by night staff. Carers logged 165 “restless” or “seizure behavior” episodes that Nelli did not deem seizures. Acceptability was 93%. The authors conclude Nelli “allowed for improved communication and care planning”. A single-center feasibility study in Dravet and Lennox-Gastaut syndromes (Wilms et al., Epilepsia, online 9 October 2025; abstract read) ran four weeks of home monitoring. It detected 368 seizures with 97.8% accuracy, while only 26.1% were logged in diaries. No individual's changed outcome is documented in any cited source.",
            "replication": {
              "produced_by": [
                "A camera and microphone unit streaming to a server where computer-vision and AI algorithms flag motor events",
                "Night-time use for people with suspected nocturnal seizures who could not tolerate EEG, with family or carer consent",
                "Clinician review of flagged clips (the Cornwall paper says 8–9% of the recording is sampled by an epilepsy expert)"
              ],
              "must_hold": [
                "Device deficiency kept low (10.5% of monitored time in the Danish validation)",
                "Staff available at night to act on alarms, the setting the validators say the system is suited to",
                "The target is major motor seizures; minor motor seizures were detected at 8.3% sensitivity"
              ],
              "echoes": [
                {
                  "date": "2025-10-09",
                  "setting": "Single-center feasibility study, 20 patients with Dravet or Lennox-Gastaut syndrome, four weeks of home monitoring in bed, August 2023 to March 2024",
                  "outcome": "recurred",
                  "source": "Wilms LK, Lossius MI, Annala K, Abdel-Khalik J, Fanter L, Elomaa K, Peltola J (2026) Epilepsia 67(1):164-174, doi:10.1111/epi.18640 (abstract: 368 seizures detected with 97.8% accuracy; 'only 26.1% of the seizures were documented' in diaries; vendor co-authors)"
                }
              ]
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
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          ],
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        },
        "review_state": "record_mapped",
        "coverage": "partial"
      }
    },
    "summary": {
      "total": 91,
      "addressed": 91,
      "known": 28,
      "reviewed": 0,
      "record_mapped": 28,
      "not_assessed": 63,
      "complete": false,
      "by_state": {
        "value_present": 28,
        "not_reported": 0,
        "unresolved": 0,
        "not_assessed": 63,
        "not_applicable": 0,
        "withheld": 0,
        "source_unavailable": 0
      }
    }
  }
}