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Quantifying severity of epileptic seizures using a wearable sensor.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death directly related to epilepsy and poses a considerable risk to people with uncontrolled epilepsy. How can we identify patients at high risk? Why does a particular seizure become fatal unlike all other seizures in the past?

Using wrist-worn biosensors, I led a clinical study on the impact of seizures on the autonomic nervous system. We found that the magnitude of autonomic changes with seizures was correlated with the duration of postictal EEG suppression. Because prolonged EEG suppression following a seizure was observed in patients who subsequently died of SUDEP, these autonomic footprints may provide biomarkers to identify patients at risk for SUDEP.


reference

M.Z. Poh, T. Loddenkemper, N.C. Swenson, S. Goyal, J.R. Madsen and R.W. Picard.
"Autonomic changes with seizures correlate with post-ictal EEG suppression."
Neurology, vol. 78, no. 23, pp. 1868-76, 2012.
[pdf] [supplementary materials]


figures


recording

Association between amplitude of EDA response and EEG suppression duration (PGES) on a patient-specific level.


system

Example of autonomic changes in electrodermal activity, heart rate variability (R-R intervals) and time-frequency mapping of R-R intervals for a single (a) complex partial seizure and (b) generalized tonic-clonic seizure.


 

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