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.
Originalsprog | Engelsk |
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Tidsskrift | Seizure |
Vol/bind | 59 |
Sider (fra-til) | 54-59 |
Antal sider | 6 |
ISSN | 1059-1311 |
DOI | |
Status | Udgivet - 2018 |