Danish Epilepsy Center, Dianalund, Denmark; Department of Clinical Neurophysiology, University of Aarhus, Aarhus, Denmark.
Epilepsia. 2013 Apr;54(4):e58-61. doi: 10.1111/epi.12120. Epub 2013 Feb 8.
Our objective was to assess the clinical reliability of a wrist-worn, wireless accelerometer sensor for detecting generalized tonic-clonic seizures (GTCS). Seventy-three consecutive patients (age 6-68 years; median 37 years) at risk of having GTCS and who were admitted to the long-term video-electroencephalography (EEG) monitoring unit (LTM) were recruited in three centers. The reference standard was considered the seizure time points identified by experienced clinical neurophysiologists, based on the video-EEG recordings and blinded to the accelerometer sensor data. Seizure time points detected real-time by the sensor were compared with the reference standard. Patients were monitored for 17-171 h (mean 66.8; total 4,878). Thirty-nine GTCS were recorded in 20 patients. The device detected 35 seizures (89.7%). In 16 patients all seizures were detected. In three patients more than two thirds of the seizures were detected. The mean of the sensitivity calculated for each patient was 91%. The mean detection latency measured from the start of the focal seizure preceding the secondarily GTCS was 55 s (95% confidence interval [CI] 38-73 s). The rate of false alarms was 0.2/day. Our results suggest that the wireless wrist accelerometer sensor detects GTCS with high sensitivity and specificity. Patients with GTCS have an increased risk for injuries related to seizures and for sudden unexpected death in epilepsy (SUDEP), and many nocturnal seizures remain undetected in unattended patients. A portable automatic seizure detection device will be an important tool for helping these patients.
我们的目的是评估一种腕戴式无线加速度计传感器检测全面性强直阵挛发作（GTCS）的临床可靠性。在三个中心共招募了 73 名连续患者（年龄 6-68 岁；中位数 37 岁），这些患者有发生 GTCS 的风险，且被收入长期视频脑电图（EEG）监测单元（LTM）。参考标准被认为是根据视频 EEG 记录由经验丰富的临床神经生理学家确定的发作时间点，且对加速度计传感器数据进行了盲法处理。传感器实时检测到的发作时间点与参考标准进行了比较。患者被监测了 17-171 小时（平均 66.8 小时；总时长 4878 小时）。在 20 名患者中记录到 39 次 GTCS。该设备检测到 35 次发作（89.7%）。在 16 名患者中，所有发作均被检测到。在 3 名患者中，超过三分之二的发作被检测到。每位患者计算的灵敏度平均值为 91%。从继发 GTCS 前的局灶性发作开始计算的平均检测潜伏期为 55 秒（95%置信区间 [CI] 38-73 秒）。假警报率为 0.2/天。我们的结果表明，无线腕部加速度计传感器以高灵敏度和特异性检测 GTCS。有 GTCS 的患者发生与癫痫发作相关的伤害和癫痫猝死（SUDEP）的风险增加，许多夜间发作在无人值守的患者中未被检测到。便携式自动癫痫发作检测设备将成为帮助这些患者的重要工具。
