I C Zibrandtsen1, P Kidmose2, T W Kjaer3. 1. Department of Neurophysiology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark. Electronic address: icz@regionsjaelland.dk. 2. Department of Engineering, Aarhus University, Aarhus, Denmark. 3. Department of Neurophysiology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark; Department of Neuroscience, University of Copenhagen, Denmark.
Abstract
PURPOSE: Sudden unexpected death in epilepsy (SUDEP) is associated with generalized tonic-clonic seizures (GTCS) with most deaths occurring during sleep. Seizure detection devices have been suggested as a SUDEP prevention strategy. EMG-based GTCS detection can take advantage of the GTCS characteristic of sustained high-amplitude, high-frequency activity in the time-domain. METHOD: We present a GTCS-detection method based on median-filtered variance estimates on surface EMG measurements and describe its performance in a small exploratory proof-of-concept setting involving a group of 15 patients with 3 GTCS recorded with ear-EEG and another group of 6 patients with 11 GTCS recorded with scalp-EEG. RESULTS: GTCS intervals were detected within 4.2-12.9 s of onset with 100% sensitivity (CI 29.2-100%) without false positives in 820.7 h of ear-EEG. The same detection method worked for the 11 GTCS from scalp EEG data with 100% sensitivity (CI 71.5-100%) and no false positives. CONCLUSIONS: Ear-EEG contains enough GTCS-specific EMG activity for GTCS detection to be feasible. Ear-EEG could be considered for nocturnal GTCS monitoring as a supplement to SUDEP preventive interventions.
PURPOSE: Sudden unexpected death in epilepsy (SUDEP) is associated with generalized tonic-clonic seizures (GTCS) with most deaths occurring during sleep. Seizure detection devices have been suggested as a SUDEP prevention strategy. EMG-based GTCS detection can take advantage of the GTCS characteristic of sustained high-amplitude, high-frequency activity in the time-domain. METHOD: We present a GTCS-detection method based on median-filtered variance estimates on surface EMG measurements and describe its performance in a small exploratory proof-of-concept setting involving a group of 15 patients with 3 GTCS recorded with ear-EEG and another group of 6 patients with 11 GTCS recorded with scalp-EEG. RESULTS: GTCS intervals were detected within 4.2-12.9 s of onset with 100% sensitivity (CI 29.2-100%) without false positives in 820.7 h of ear-EEG. The same detection method worked for the 11 GTCS from scalp EEG data with 100% sensitivity (CI 71.5-100%) and no false positives. CONCLUSIONS: Ear-EEG contains enough GTCS-specific EMG activity for GTCS detection to be feasible. Ear-EEG could be considered for nocturnal GTCS monitoring as a supplement to SUDEP preventive interventions.
Authors: Andrea Biondi; Viviana Santoro; Pedro F Viana; Petroula Laiou; Deb K Pal; Elisa Bruno; Mark P Richardson Journal: Epilepsia Date: 2022-03-27 Impact factor: 6.740