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Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography.

Publication ,  Journal Article
Husain, AM; Towne, AR; Chen, DK; Whitmire, LE; Voyles, SR; Cardenas, DP
Published in: J Clin Neurophysiol
September 1, 2021

PURPOSE: Epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) are difficult to differentiate when based on a patient's self-reported symptoms. This study proposes review of objective data captured by a surface electromyography (sEMG) wearable device for classification of events as ES or PNES. This may help clinicians accurately identify ES and PNES. METHODS: Seventy-one subjects were prospectively enrolled across epilepsy monitoring units at VA Epilepsy Centers of Excellence. Subjects were concomitantly monitored using video EEG and a wearable sEMG epilepsy monitor, the Sensing Portable sEmg Analysis Characterization (SPEAC) System. Three epileptologists independently classified ES and PNES that contained upper extremity motor activity based on video EEG. The sEMG data from those events were automatically processed to provide a seizure score for event classification. After brief training (60 minutes), the sEMG data were reviewed by a separate group of four epileptologists to independently classify events as ES or PNES. RESULTS: According to video EEG review, 17 subjects experienced 34 events (15 ES and 19 PNES with upper extremity motor activity). The automated process correctly classified 87% of ES (positive predictive value = 88%, negative predictive value = 76%) and 79% of PNES, and the expert reviewers correctly classified 77% of ES (positive predictive value = 94%, negative predictive value = 84%) and 96% of PNES. The automated process and the expert reviewers correctly classified 100% of tonic-clonic seizures as ES, and 71 and 50%, respectively, of non-tonic-clonic ES. CONCLUSIONS: Automated and expert review, particularly in combination, of sEMG captured by a wearable seizure monitor (SPEAC System) may be able to differentiate ES (especially tonic-clonic) and PNES with upper extremity motor activity.

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Published In

J Clin Neurophysiol

DOI

EISSN

1537-1603

Publication Date

September 1, 2021

Volume

38

Issue

5

Start / End Page

432 / 438

Location

United States

Related Subject Headings

  • Seizures
  • Neurology & Neurosurgery
  • Mental Disorders
  • Humans
  • Epilepsy
  • Electromyography
  • Electroencephalography
  • 5203 Clinical and health psychology
  • 5202 Biological psychology
  • 3209 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
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Husain, A. M., Towne, A. R., Chen, D. K., Whitmire, L. E., Voyles, S. R., & Cardenas, D. P. (2021). Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography. J Clin Neurophysiol, 38(5), 432–438. https://doi.org/10.1097/WNP.0000000000000703
Husain, Aatif M., Alan R. Towne, David K. Chen, Luke E. Whitmire, Shannon R. Voyles, and Damon P. Cardenas. “Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography.J Clin Neurophysiol 38, no. 5 (September 1, 2021): 432–38. https://doi.org/10.1097/WNP.0000000000000703.
Husain AM, Towne AR, Chen DK, Whitmire LE, Voyles SR, Cardenas DP. Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography. J Clin Neurophysiol. 2021 Sep 1;38(5):432–8.
Husain, Aatif M., et al. “Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography.J Clin Neurophysiol, vol. 38, no. 5, Sept. 2021, pp. 432–38. Pubmed, doi:10.1097/WNP.0000000000000703.
Husain AM, Towne AR, Chen DK, Whitmire LE, Voyles SR, Cardenas DP. Differentiation of Epileptic and Psychogenic Nonepileptic Seizures Using Single-Channel Surface Electromyography. J Clin Neurophysiol. 2021 Sep 1;38(5):432–438.

Published In

J Clin Neurophysiol

DOI

EISSN

1537-1603

Publication Date

September 1, 2021

Volume

38

Issue

5

Start / End Page

432 / 438

Location

United States

Related Subject Headings

  • Seizures
  • Neurology & Neurosurgery
  • Mental Disorders
  • Humans
  • Epilepsy
  • Electromyography
  • Electroencephalography
  • 5203 Clinical and health psychology
  • 5202 Biological psychology
  • 3209 Neurosciences