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Post‐ictal accelerometer silence as a marker of post‐ictal immobility
Author(s) -
Bruno Elisa,
Böttcher Sebastian,
Biondi Andrea,
Epitashvili Nino,
Manyakov Nikolay V.,
Lees Simon,
SchulzeBonhage Andreas,
Richardson Mark P.
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16552
Subject(s) - ictal , epilepsy , duration (music) , medicine , psychology , audiology , electroencephalography , silence , neuroscience , physics , acoustics
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.