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Seizure. 2016 Jul;39:13-18. doi: 10.1016/j.seizure.2016.04.009. Epub 2016 Apr 29.

Tracking generalized tonic-clonic seizures with a wrist accelerometer linked to an online database.

Author information

1
Stanford University School of Medicine, Department of Neurology, Stanford Comprehensive Epilepsy Center, 213 Quarry Drive, 5979, Palo Alto, CA, 94304, USA.
2
Harvard University, Cambridge, MA, USA.
3
Stanford University School of Medicine, Department of Neurology, Stanford Comprehensive Epilepsy Center, 213 Quarry Drive, 5979, Palo Alto, CA, 94304, USA. Electronic address: schele@stanford.edu.

Abstract

PURPOSE:

Clinical management of epilepsy and current epilepsy therapy trials rely on paper or electronic diaries often with inaccurate self-reported seizure frequency as the primary outcome. This is the first study addressing the feasibility of detecting and recording generalized tonic-clonic seizures (GTCS) through a biosensor linked to an online seizure database.

METHOD:

A prospective trial was conducted with video-EEG (vEEG) in an epilepsy monitoring unit. Patients wore a wristwatch accelerometer that detected shaking and transmitted events via Bluetooth® to a bedside electronic tablet and then via Wi-Fi to an online portal. The watch recorded the date, time, audio, duration, frequency and amplitude of events. Events logged by the watch and recorded in a bedside paper diary were measured against vEEG, the "gold standard."

RESULTS:

Thirty patients were enrolled and 62 seizures were recorded on vEEG: 31 convulsive and 31 non-convulsive. Twelve patients had a total of 31 convulsive seizures, and of those, 10 patients had 13 GTCS. The watch captured 12/13 (92.3%) GTCS. Watch audio recordings were consistent with seizures in 11/12 (91.6%). Data were successfully transferred to the bedside tablet in 11/12 (91.6%), and to the online database in 10/12 (83.3%) GTCS. The watch recorded 81 false positives, of which 42/81 (51%) were cancelled by the patients. Patients and caregivers verbally reported 15/62 seizures (24.2% sensitivity) but no seizures were recorded on paper logs.

CONCLUSION:

Automatic detection and recording of GTCS to an online database is feasible and may be more informative than seizure logging in a paper diary.

KEYWORDS:

Automatic detection; Epilepsy; Online interface; Seizure diary

PMID:
27205871
DOI:
10.1016/j.seizure.2016.04.009
[Indexed for MEDLINE]
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