Highlights
- •We evaluated an under-mattress seizure detection tool (Emfit®) in an adult epilepsy monitoring unit.
- •Sensitivity of the tool for detecting convulsive seizures was 69.6% with a false alarm rate of 0.007/24 h.
- •Nurses intervened much more frequently (100% vs 57%) in the event of the alarm being triggered.
Abstract
Objective
Because of SUDEP (Sudden and unexpected death in epilepsy) and other direct consequences
of generalized tonic-clonic seizures, the use of efficient seizure detection tool
may be helpful for patients, relatives and caregivers. We aimed to evaluate an under-mattress
detection tool (EMFIT®) in real-life hospital conditions, in particular its sensitivity
and false alarm rate (FAR), as well as its impact on patient care.
Methods
We carried out a retrospective study on a cohort of patients with epilepsy admitted
between September 2017 and June 2021 to Amiens University Hospital for a video-EEG
of at least 24 h, during which at least one epileptic seizure was recorded. All video-EEGs
records were analyzed visually in order to assess the sensitivity of the under-mattress
tool (triggering of the alarm) and to classify the seizure type (convulsive/non convulsive).
We also considered whether nurses intervened during the seizure, and the time of their
intervention if applicable. An additional prospective survey was conducted over 272
days to analyze the FAR of the tool.
Results
A total of 220 seizures were included in the study, from 55 patients, including 23
convulsive seizures from 15 patients and 197 non-convulsive seizures. Sensitivity
for convulsive seizure detection was 69.6%. As expected, none of the non-convulsive
seizures was detected. The false alarm rate was 0.007/day. Median trigger time was
74 s, decreasing to 5 s for generalized tonic-clonic seizure. The frequency of nurses’
intervention during convulsive seizures was significantly greater in case of the alarm
triggering (100% vs 57%, p<0.02).
Significance
These results suggest that EMFIT® sensor is able to detect convulsive seizures with
good sensitivity and low FAR, and allows caregivers to intervene more often in the
event of a nocturnal seizure. This would be an interesting complementary tool to better
secure the patients with epilepsy during hospitalization or at home.
Keywords
Abbreviations:
SUDEP (Sudden Unexpected Death in EPilepsy), FAR (False Alarm Rate), EEG (ElectroEncephaloGram), EMU (epilepsy monitoring unit)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Seizure - European Journal of EpilepsyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Drug resistance in epilepsy: clinical impact, potential mechanisms, and new innovative treatment options.Pharmacol Rev. 2020; 72 (Barker EL, editor): 606-638
- Mortality in epilepsy.J Neurol. 2000; 247: 15-21
- Cause-specific mortality in epilepsy.Epilepsia. 2005; 46: 36-39
- Sudden unexpected death in epilepsy (SUDEP): definition, epidemiology, and significance of education.Epilepsy Behavior. 2022; 132108742
- Sudden unexpected death in epilepsy (SUDEP): what every neurologist should know.Epileptic Disord. 2017; 19: 1-9
- Sudden unexpected death in epilepsy (SUDEP): a review of risk factors and possible interventions in children.J Pediatr Pharmacold Therapeutics. 2021; 26: 556-564
- The role of convulsive seizures in SUDEP.Auton Neurosci. 2021; 235102856
- Thijs RD. Nocturnal supervision and SUDEP risk at different epilepsy care settings.Neurology. 2018; 91: e1508-e1518
- Can we prevent sudden unexpected death in epilepsy (SUDEP)?.Can J Neurol Sci. 2021; 48: 464-468
- Diagnostic challenges in epilepsy: seizure under-reporting and seizure detection.Lancet Neurol. 2018; 17: 279-288
- Commercially available seizure detection devices: a systematic review.J Neurol Sci. 2021; 428117611
- Automated seizure detection with noninvasive wearable devices: a systematic review and meta-analysis.Epilepsia. 2022; 63: 1930-1941
- Noninvasive detection of focal seizures in ambulatory patients.Epilepsia. 2020; 61 ([online serial]Accessed at:) (Accessed October 11, 2022)
- [Wearable devices for automated seizure detection].Ugeskr Laeger. 2022; 184V10210770
- Automated seizure detection using wearable devices: a clinical practice guideline of the International League Against Epilepsy and the International Federation of Clinical Neurophysiology.Clin Neurophysiol. 2021; 132: 1173-1184
- Assessment of a quasi-piezoelectric mattress monitor as a detection system for generalized convulsions.Epilepsy Behav. 2013; 28: 172-176
- ElectroMechanical Film (EMFi) — a new multipurpose electret material.Sens Actuators A. 2000; 84: 95-102
- Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE commission for classification and terminology.Epub. 2017; 9
- Standards for testing and clinical validation of seizure detection devices.Epilepsia. 2018; 59: 9-13
- Prospective study of the Emfit movement monitor.J Child Neurol. 2013; 28: 1434-1436
- Safety at The William Quarrier Scottish epilepsy centre.Seizure. 2017; 53: 10-12
- First do no harm: safety in the epilepsy monitoring unit.Epilepsy Curr. 2009; 9: 162-163
- Improving safety outcomes in the epilepsy monitoring unit.Seizure. 2012; 21: 124-127
- Seizure detection at home: do devices on the market match the needs of people living with epilepsy and their caregivers?.Epilepsia. 2020; 61 ([online serial]Accessed at:) (Accessed October 11, 2022.)
- Seizure detection devices and health-related quality of life: a patient- and caregiver-centered evaluation.Epilepsy Behav. 2020; 105106963
- Seizure detection devices: a survey of needs and preferences of patients and caregivers.Epilepsy Behav. 2021; 114107607
- Strategies for non-EEG seizure detection and timing for alerting and interventions with tonic-clonic seizures.Epilepsia. 2018; 59: 36-41
- Staff response times in the epilepsy monitoring unit: a study of diurnal/nocturnal variability.Neurodiagn J. 2017; 57: 269-275
Article info
Publication history
Published online: January 12, 2023
Accepted:
January 8,
2023
Received in revised form:
January 6,
2023
Received:
October 19,
2022
Identification
Copyright
© 2023 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
