Abstract
Automatic computer-based seizure detection and warning devices are important for objective seizure documentation, for SUDEP prevention, to avoid seizure related injuries and social embarrassments as a consequence of seizures, and to develop on demand epilepsy therapies. Automatic seizure detection systems can be based on direct analysis of epileptiform discharges on scalp-EEG or intracranial EEG, on the detection of motor manifestations of epileptic seizures using surface electromyography (sEMG), accelerometry (ACM), video detection systems and mattress sensors and finally on the assessment of changes of physiologic parameters accompanying epileptic seizures measured by electrocardiography (ECG), respiratory monitors, pulse oximetry, surface temperature sensors, and electrodermal activity. Here we review automatic seizure detection based on scalp-EEG, ECG, and sEMG. Different seizure types affect preferentially different measurement parameters. While EEG changes accompany all types of seizures, sEMG and ACM are suitable mainly for detection of seizures with major motor manifestations. Therefore, seizure detection can be optimized by multimodal systems combining several measurement parameters. While most systems provide sensitivities over 70%, specificity expressed as false alarm rates still needs to be improved. Patients' acceptance and comfort of a specific device are of critical importance for its long-term application in a meaningful clinical way.
Highlights
Automatic seizure detection must be distinguished from automatic seizure prediction
We focused our review on automatic seizure detection based on scalp electroencephalography, electrocardiography (ECG) and surface electromyography because these modalities have been studied most extensively in the literature
Automatic computer-based seizure detection and warning devices are important for objective seizure documentation, for Sudden unexpected death in epilepsy (SUDEP) prevention, to avoid seizure related injuries and social embarrassments as a consequence of seizures, and to develop on demand epilepsy therapies
Summary
Automatic seizure detection must be distinguished from automatic seizure prediction. Automatic seizure detection systems and warning devices could help to prevent seizure associated injuries [10]. This would significantly reduce the fear of seizures and improve the quality of life for persons with epilepsy [16]. 5. During video-EEG-monitoring (VEM) in the epilepsy monitoring unit (EMU), applications for automatic seizure detection systems include enhancement of patient safety, more efficient data analysis, automatic documentation of seizures, and computer-based neurological and neuropsychological testing during and after seizures. Automatic on-line seizure detection and warning systems could provide a significantly less personnel intensive alternative to personal patient surveillance in the EMU. Automatic seizure detection has become increasingly important for the detection of non-convulsive seizures and non-convulsive status epilepticus in critical care patients [35]
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