title: Assessment of a quasi-piezoelectric mattress monitor as a detection system for generalized convulsions.
abstract: The risk of sudden unexpected death in epilepsy (SUDEP) is highest with nocturnal, unattended generalized convulsions, and basic resuscitation may be able to prevent SUDEP. This study investigates an under-mattress device (ElectroMechanical Film - Emfit®) which is triggered by rhythmic motor activity of a specifiable duration, frequency, and intensity using a quasi-piezoelectric material sensitive to changes in mattress pressure. The device was tested during inpatient video-EEG monitoring. Eighteen GTCSs were recorded, 10 out of wakefulness and 8 out of sleep. Sixteen of the 18 seizures (89%) resulted in Emfit® activation with both false negative alarms occurring during wakefulness. On average, the device was activated within 9 s of onset of bilateral clonic motor movements (range: -37 to +39 s) and occurred, on average, 45 s before seizure end (range: 19 to 76 s). Only 21 false alarms were encountered, all occurring during wakefulness (PPV: 43%). The data suggest that the Emfit® detection device has a high predictive value for generalized convulsions, offers caregivers a reliable and early warning to assist the patient during convulsions, and may be a novel way to prevent SUDEP.
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Northwestern University Feinberg School of Medicine, USA.
authors.forename: Aditi P
authors.initials: AP
authors.lastname: Narechania
authors.forename: Irena I
authors.initials: II
authors.lastname: Garić
authors.forename: Indranil
authors.initials: I
authors.lastname: Sen-Gupta
authors.forename: Mícheál P
authors.initials: MP
authors.lastname: Macken
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Gerard
authors.forename: Stephan U
authors.initials: SU
authors.lastname: Schuele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001513:Beds; D056902:Clinical Alarms; D003645:Death, Sudden / Q000517:prevention & control; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology; D018709:Statistics, Nonparametric; D055815:Young Adult