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Post-ictal accelerometer silence as a marker of post-ictal immobility.

Abstract：

OBJECTIVE:Movement-based wearable sensors are used for detection of convulsive seizures. The identification of the absence of motion following a seizure, known as post-ictal immobility (PI), may represent a potential additional application of wearables. PI has been associated with potentially life-threatening complications and with sudden unexpected death in epilepsy (SUDEP). We aimed to assess whether wearable accelerometers (ACCs) could be used as a digital marker of PI. METHOD:Devices with embedded ACCs were worn by patients admitted to an epilepsy monitoring unit. Participants presenting with convulsive seizures were included in the study. PI presence and duration were assessed by experts reviewing video recordings. An algorithm for the automatic detection of post-ictal ACC silence and its duration was developed and the linear pairwise relationship between the automatically detected duration of post-ictal ACC silence and the duration of the expert-labeled PI was analyzed. RESULTS:Twenty-two convulsive seizures were recorded from 18 study participants. Twenty were followed by PI and two by agitation. The automated estimation of post-ictal ACC silence identified all the 20 expert-labeled PI. The regression showed that the duration of the post-ictal ACC silence was correlated with the duration of PI (Pearson r = .92; P < .001), with the age of study participants (Pearson r = .78; P < .001), and with the duration of post-ictal generalized electroencephalography suppression (PGES; Pearson r = .4; P = .033). SIGNIFICANCE:We highlight a novel application of wearables as a way to record post-ictal manifestations associated with an increased risk of SUDEP. The occurrence of a fatal seizure is unpredictable and the continuous, non-invasive, long-term identification of risk factors associated with each individual seizure may assume a great clinical importance.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Bruno E,Böttcher S,Biondi A,Epitashvili N,Manyakov NV,Lees S,Schulze-Bonhage A,Richardson MP,RADAR-CNS Consortium.

doi

10.1111/epi.16552

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

1397-1405

issue

eissn

0013-9580

issn

1528-1167

journal_volume

pub_type

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Post-ictal accelerometer silence as a marker of post-ictal immobility.