Bongers Jos, Gutierrez-Quintana Rodrigo, Stalin Catherine Elizabeth
Neurology and Neurosurgery Service, The School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Front Vet Sci. 2022 May 23;9:896030. doi: 10.3389/fvets.2022.896030. eCollection 2022.
The unpredictable nature of seizures is challenging for caregivers of epileptic dogs, which calls the need for other management strategies such as seizure detection devices. Seizure detection devices are systems that rely on non-electroencephalographic (non-EEG) ictal changes, designed to detect seizures. The aim for its use in dogs would be to provide owners with a more complete history of their dog's seizures and to help install prompt (and potentially life-saving) intervention. Although seizure detection via wearable intracranial EEG recordings is associated with a higher sensitivity in humans, there is robust evidence for reliable detection of generalized tonic-clonic seizures (GTCS) using non-EEG devices. Promising non-EEG changes described in epileptic humans, include heart rate variability (HRV), accelerometry (ACM), electrodermal activity (EDA), and electromyography (EMG). Their sensitivity and false detection rate to detect seizures vary, however direct comparison of studies is nearly impossible, as there are many differences in study design and standards for testing. A way to improve sensitivity and decrease false-positive alarms is to combine the different parameters thereby profiting from the strengths of each one. Given the challenges of using EEG in veterinary clinical practice, non-EEG ictal changes could be a promising alternative to monitor seizures more objectively. This review summarizes various seizure detection devices described in the human literature, discusses their potential use and limitations in veterinary medicine and describes what is currently known in the veterinary literature.
癫痫发作的不可预测性对患有癫痫的犬只的护理人员来说是一项挑战,这就需要其他管理策略,如癫痫发作检测设备。癫痫发作检测设备是依靠非脑电图(非EEG)发作期变化来检测癫痫发作的系统。将其用于犬只的目的是为犬主提供其犬只癫痫发作更完整的病史,并有助于进行及时(且可能挽救生命)的干预。尽管通过可穿戴式颅内脑电图记录检测癫痫发作在人类中具有更高的灵敏度,但有确凿证据表明使用非EEG设备可可靠检测全身性强直阵挛发作(GTCS)。在患有癫痫的人类中描述的有前景的非EEG变化包括心率变异性(HRV)、加速度测量(ACM)、皮肤电活动(EDA)和肌电图(EMG)。然而,它们检测癫痫发作的灵敏度和误检率各不相同,由于研究设计和测试标准存在许多差异,几乎不可能对各项研究进行直接比较。提高灵敏度并减少误报的一种方法是将不同参数结合起来,从而利用每个参数的优势。鉴于在兽医临床实践中使用脑电图存在挑战,非EEG发作期变化可能是更客观监测癫痫发作的一种有前景的替代方法。这篇综述总结了人类文献中描述的各种癫痫发作检测设备,讨论了它们在兽医学中的潜在用途和局限性,并描述了兽医文献中目前已知的情况。