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Abstract Details

Development of a Seizure Warning System Based on Continuous Cerebral Blood Flow Measurement
Epilepsy/Clinical Neurophysiology (EEG)
S48 - (-)
003
A reliable method to predict epileptic seizure onset is needed. Continuous CBF (CCBF) measurement using subdurally implanted thermistor probes has been widely employed for the management of head injury in patients. However, no seizure prediction method has been developed based on CBF measurement.
CCBF of 7 epileptic patients undergoing invasive monitoring for localization of the seizure focus, along with electrocorticography (ECoG), was measured using commercial thermistor probes subdurally implanted over anterior temporal lobes bilaterally, in the peri-ictal period. We employed cumulative sum as part of the time series analysis, and approximate and sample entropies as part of the signal complexity measures. The duration of anticipation (DA) was determined as the difference between the onset time indicated by CCBF measurement and that indicated by the electrical signal.
As the seizure onset phase approaches, the CBF data demonstrate a significant decrease in complexity. During the onset phase, there is a consistent shift in the trend of the CBF data and a significant drop in the data complexity. DA was 24 seconds to 15.7 minutes (Mean 卤 SD = 5.3 卤 6.4 min). In 3 of the 7 patients, DA was more than 7 minutes, suggesting that CCBF monitoring may be able to provide warning at least 7 minute in advance of seizure. The algorithm can also predict seizure more than 5 minutes ahead in about half of the patients studied.
CCBF measurement may be able to provide valuable warning significantly in advance of seizure. Further clinical studies are needed to improve and validate the proposed CBF algorithm.
Authors/Disclosures
Kalarickal Oommen, MD, FAAN (Covenant Medical Group)
PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
Bruce A. Cree, MD, PhD, MAS, FAAN (UCSF, Multiple Sclerosis Center) The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autobahn. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avotres. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon. Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neuron23. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Pharma. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal/Sandoz. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyverna. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. The institution of Dr. Cree has received research support from Genentech. The institution of Dr. Cree has received research support from Kyverna. Dr. Cree has received publishing royalties from a publication relating to health care.