RNS-defined long events (LE), locations and hourly IEA were matched with hourly CGM of tissue glucose over a continuous 3-year period without any RNS detection setting changes. “Active” and "Quiet" IEA periods were defined by Z-scoring daily IEA and retaining consecutive 4-day intervals with Z>1 and Z<-1 respectively. A second analysis studied LE and confirmed ictal/seizure activities. If multiple events occurred within 4 days, they were designated “active.” Average glucose levels during active and quiet periods were compared using two-tailed t-tests. 4-day minimum intervals defined epochs as they were the most common duration between seizures.

Average glucose during active (n=121) and quiet (n=110) IEA was 165 mg/dl and 150 mg/dl respectively (p=0.01). Average glucose during active (n=61) and quiet (n=43) Ictal periods was 161 mg/dl and 151 mg/dl respectively (p>0.3). LE that were not clearly seizures (n=123) showed an average glucose of 180 mg/dl while LE that were clearly seizures (n=104) showed an average glucose of 157 mg/dl (p=0.02).

Glucose elevations are evident during epochs of volatile IEA and RNS evident “long events” that are NOT clearly seizures. However, for clearly evident seizure, glucose does not differ between active and inactive multidien clusters.