Int J Neural Syst - Automated seizure detection using EKG.

Tópicos

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Resumo

Changes in heart rate, most often increases, are associated with the onset of epileptic seizures and may be used in lieu of cortical activity for automated seizure detection. The feasibility of this aim was tested on 241 clinical seizures from 81 subjects admitted to several Epilepsy Centers for invasive monitoring for evaluation for epilepsy surgery. The performance of the EKG-based seizure detection algorithm was compared to that of a validated algorithm applied to electrocorticogram (ECoG). With the most sensitive detection settings [threshold T: 1.15; duration D: 0 s], 5/241 seizures (2%) were undetected (false negatives) and with the highest [T: 1.3; D: 5 s] settings, the number of false negative detections rose to 34 (14%). The rate of potential false positive (PFP) detections was 9.5/h with the lowest and 1.1/h with the highest T, D settings. Visual review of 336 ECoG segments associated with PFPs revealed that 120 (36%) were associated with seizures, 127 (38%) with bursts of epileptiform discharges and only 87 (26%) were true false positives. Electrocardiographic (EKG)-based seizure onset detection preceded clinical onset by 0.8 s with the lowest and followed it by 13.8 s with the highest T, D settings. Automated EKG-based seizure detection is feasible and has potential clinical utility given its ease of acquisition, processing, high signal/noise and ergonomic advantages viz-a-viz EEG (electroencephalogram) or ECoG. Its use as an "electronic" seizure diary will remedy in part, the inaccuracies of those generated by patients/care-givers in a cost-effective manner.

Resumo Limpo

chang heart rate often increas associ onset epilept seizur may use lieu cortic activ autom seizur detect feasibl aim test clinic seizur subject admit sever epilepsi center invas monitor evalu epilepsi surgeri perform ekgbas seizur detect algorithm compar valid algorithm appli electrocorticogram ecog sensit detect set threshold t durat d s seizur undetect fals negat highest t d s set number fals negat detect rose rate potenti fals posit pfp detect h lowest h highest t d set visual review ecog segment associ pfps reveal associ seizur burst epileptiform discharg true fals posit electrocardiograph ekgbas seizur onset detect preced clinic onset s lowest follow s highest t d set autom ekgbas seizur detect feasibl potenti clinic util given eas acquisit process high signalnois ergonom advantag vizaviz eeg electroencephalogram ecog use electron seizur diari will remedi part inaccuraci generat patientscaregiv costeffect manner

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