Epileptic seizure detection requires specialized approaches such as video/electroencephalography monitoring. However, these approaches are restricted mainly to hospital setting and requires video/EEG analysis by experts, which makes these approaches resource- and labor-intensive. In contrast, we aim to develop a wireless, remote monitoring system using a single wrist-worn accelerometer sensor, which is sensitive to multiple types of convulsive seizures and is capable of detecting seizures with short duration. Simple time domain features including a new set of Poincare plot based features were extracted from the active movement events recorded using a wrist-worn accelerometer sensor. The best features were then selected using the area under the ROC curve analysis. Kernelized support vector data description (SVDD) was then used to classify non-seizure and seizure events. The proposed algorithm was evaluated on 5,576h of recordings from 79 patients and detected 40 (86.95%) of 46 convulsive seizures (generalized tonic-clonic (GTCS), psychogenic non-epileptic (PNES), and complex partial seizures (CPS)) from twenty patients with a total of 270 false alarms (1.16/24h). Furthermore, the algorithm showed a comparable performance (sensitivity 95.23% and false alarm rate 0.64/24h) with respect to existing unimodal and multi-modal methods for GTCS detection. The promising results shows the potential to build an ambulatory monitoring convulsive seizure detection system. A wearable accelerometer based seizure detection system would aid in continuous assessment of convulsive seizures in a timely and non-invasive manner.

Epilepsy is one of the most common neurological disorders and patients suffer from unprovoked seizures. In contrast, psychogenic nonepileptic seizures (PNES) are another class of seizures that are involuntary events not caused by abnormal electrical discharges but are a manifestation of psychological distress. The similarity of these two types of seizures poses diagnostic challenges that often leads in delayed diagnosis of PNES. Further, the diagnosis of PNES involves high-cost hospital admission and monitoring using video-electroencephalogram machines. A wearable device that can monitor the patient in natural setting is a desired solution for diagnosis of convulsive PNES. A wearable device with an accelerometer sensor is proposed as a new solution in the detection and diagnosis of PNES. The seizure detection algorithm and PNES classification algorithm are developed. The developed algorithms are tested on data collected from convulsive epileptic patients. A very high seizure detection rate is achieved with 100% sensitivity and few false alarms. A leave-one-out error of 6.67% is achieved in PNES classification, demonstrating the usefulness of wearable device in the diagnosis of PNES.

Objective Accurate differentiation between epileptic seizures (ES) and psychogenic non‐epileptic seizures (PNES) can be challenging based on history alone. Inpatient video EEG monitoring (VEM) is often needed for a definitive diagnosis. However, VEM is highly resource intensive, is of limited availability, and cannot be undertaken over long periods. Previous research has shown that time‐frequency analysis of accelerometer data could be utilized to differentiate between ES and PNES. Using a seizure detection and classification algorithm, we sought to examine the diagnostic utility of an automated analysis with an ambulatory accelerometer. Methods A wrist‐worn device was used to collect accelerometer data from patients during VEM admission, for diagnostic evaluation of convulsive seizures. An automated process, that involved the use of K‐means clustering and support vector machines, was used to detect and classify each seizure as ES or PNES. The results were compared with VEM diagnoses determined by epileptologists blinded to the accelerometer data. Results Twenty‐four convulsive seizures, consisting of at least 20 seconds of sustained continuous activity, recorded from 11 patients during inpatient VEM (13 PNES from five patients and 11 ES from six patients) were included for analysis. The automated system detected all convulsive seizures (ES, PNES) from >661 hours of recording with 67 false alarms (2.4 per 24 hours). The sensitivity and specificity for classifying ES from PNES were 72.7% and 100%, respectively. The positive and negative predictive values for classifying PNES were 81.3% and 100%, respectively. There was no significant difference between the classification results obtained from the automation process and the VEM diagnoses. Significance This automated system can potentially provide a wearable out‐of‐hospital seizure diagnostic monitoring system.

Vascular stiffness is an indicator of cardiovascular health, with carotid artery stiffness having established correlation to coronary heart disease and utility in cardiovascular diagnosis and screening. State of art equipment for stiffness evaluation are expensive, require expertise to operate and not amenable for field deployment. In this context, we developed ARTerial Stiffness Evaluation for Noninvasive Screening (ARTSENS), a device for image free, noninvasive, automated evaluation of vascular stiffness amenable for field use. ARTSENS has a frugal hardware design, utilizing a single ultrasound transducer to interrogate the carotid artery, integrated with robust algorithms that extract arterial dimensions and compute clinically accepted measures of arterial stiffness. The ability of ARTSENS to measure vascular stiffness in vivo was validated by performing measurements on 125 subjects. The accuracy of results was verified with the state-of-the-art ultrasound imaging-based echo-tracking system. The relation between arterial stiffness measurements performed in sitting posture for ARTSENS measurement and sitting/supine postures for imaging system was also investigated to examine feasibility of performing ARTSENS measurements in the sitting posture for field deployment. This paper verified the feasibility of the novel ARTSENS device in performing accurate in vivo measurements of arterial stiffness. As a portable device that performs automated measurement of carotid artery stiffness with minimal operator input, ARTSENS has strong potential for use in large-scale screening.