Tracking generalized tonic clonic seizures with a wrist accelerometer linked to an online database
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(r) 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.
Seizure