title: Is seizure detection based on EKG clinically relevant?
abstract: OBJECTIVE
  Real-time EKG-based automated seizure detection is emerging as a complement or supplement to that based on cortical signals, but its value is unproven. This study assesses the clinically relevance of EKG-based seizure detection by comparing the information content in EKG and ECoG.
  
  
  METHODS
  ECoGs (6935h; 241 clinical and 4311 sub-clinical seizures) with simultaneous EKG from 81 subjects undergoing surgical evaluation were used in these analyses. Differences, if any, between clinical and sub-clinical seizures in variables such as intensity, duration and their product severity, were investigated with a multi-variate regression model.
  
  
  RESULTS
  Highly statistically significant differences in severity between clinical and sub-clinical seizures were discerned with EKG and ECoG. Furthermore, EKG-based seizure severity was linearly correlated with that estimated using ECoG.
  
  
  CONCLUSIONS
  These findings support the notion that EKG-based seizure detection is clinically relevant in certain localization-related epilepsies, providing similar information to that yielded by neuronal electrical signals.
  
  
  CONCLUSIONS
  The information content equivalence between EKG and ECoG would enable automated seizure detection, quantification and therapy delivery, without resorting to cortical monitoring. The considerably higher S/N and ease of acquisition and processing of EKG compared to ECoG/EEG may foster widespread clinical applications of this novel detection approach.
authors.affiliation: Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, United States. Electronic address: iosorio@kumc.edu.
authors.forename: Ivan
authors.initials: I
authors.lastname: Osorio
authors.affiliation: Western EcoSystems Technology, Inc., Cheyenne, WY, United States.
authors.forename: B F J
authors.initials: BF
authors.lastname: Manly
mesh_terms: D000465:Algorithms; D002540:Cerebral Cortex / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods / Q000592:standards*; D004569:Electroencephalography / Q000379:methods / Q000592:standards*; D006801:Humans; D012640:Seizures / Q000175:diagnosis*; D012720:Severity of Illness Index
keywords: Clinical; ECoG-based detection; EKG-based detection; Seizures; Severity; Sub-clinical