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Seizure detection in adult ICU patients based on changes in EEG synchronization likelihood

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Abstract

Introduction

Seizures are common in Intensive Care Unit (ICU) patients, and may increase neuronal injury.

Purpose

To explore the possible value of synchronization likelihood (SL) for the automatic detection of seizures in adult ICU patients.

Methods

We included EEGs from ICU patients with a variety of diagnoses. The gold standard for further analyses was the consensus judgment of three clinical neurophysiologists who classified 150 scalp EEG epochs as “definitely epileptiform,” “definitely nonepileptiform,” or “uncertain.” SL estimates the statistical interdependencies between two time series, such as two EEG channels. We computed the average synchronization by calculating the SL between one channel and every other channel, and taking the mean of these values.

Results

The mean SL in the 38 “definitely epileptiform” epochs ranged from 0.095 to 0.386 (mean 0.189; SD 0.066). In the 34 “definitely nonepileptiform” epochs the mean SL ranged from 0.087 to 0.158 (mean 0.115; SD 0.016; p<0.0005). The area under the ROC curve was 0.812 (95% Confidence Interval 0.725 to 0.898).

Conclusion

The mean SL may distinguish between seizure and nonseizure epochs, and may prove helpful to monitor epileptic activity in ICU patients.

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Authors and Affiliations

  1. Department of Intensive Care, University Medical Center, Utrecht, the Netherlands

    A. J. C. Slooter

  2. Department of Intensive Care, VU University Medical Center, Amsterdam, the Netherlands

    J. J. Spijkstra & A. R. J. Girbes

  3. Rudolf Magnus Institute for Neurosciences, Department of Clinical Neurophysiology, University Medical Center, Utrecht, the Netherlands

    F. S. S. Leijten & A. C. van Huffelen

  4. Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands

    E. M. Vriens &  C. J. Stam

Authors
  1. A. J. C. Slooter
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  2. E. M. Vriens
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  3. F. S. S. Leijten
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  4. J. J. Spijkstra
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  5. A. R. J. Girbes
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  6. A. C. van Huffelen
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  7. C. J. Stam
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Corresponding author

Correspondence to C. J. Stam.

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Slooter, A.J.C., Vriens, E.M., Leijten, F.S.S. et al. Seizure detection in adult ICU patients based on changes in EEG synchronization likelihood. Neurocrit Care 5, 186–192 (2006). https://doi.org/10.1385/NCC:5:3:186

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  • DOI: https://doi.org/10.1385/NCC:5:3:186

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