Non-invasive Seizure Detection Using Wearable Wrist-worn Accelerometry and Deep Learning

Seizure monitoring and detection are crucial for reducing the morbidity and mortality associated with seizures. Current epilepsy care, often involving expensive video-electroencephalography (VEEG) monitoring, requires specialized expertise and is limited to in-hospital settings, and intrusive in nature. Seizure diaries, on the other hand, suffer from unreliability due to under-reporting, leading to incorrect therapeutic decisions. Wearable non-invasive seizure detection may offer a more tolerable and feasible solution for long-term ambulatory monitoring. This study explores a wearable remote monitoring system utilizing a single wrist-worn accelerometer device and capable of detecting multiple types of seizures, including shorter duration events. We enrolled 79 patients under video-electroencephalography monitoring to wear accelerometer devices and collect data. Concurrent VEEG recordings were reviewed by board-certified epileptologists to produce annotations, including seizure onset, offset, and seizure type. Using this data, we constructed a deep neural network based on the time-series ResNet architecture, which could discriminate among seizure and non-seizure events. Our proposed approach achieved a seizure detection sensitivity of 95.65% and an overall false alarm rate of 0.15/24 hours during the evaluation, which spanned 5576 hours of total recording. Additionally, it resulted in an area under the receiver operating characteristic curve (AUC-ROC) of 0.98 and an area under the precision-re call curve (AUC-PRC) of 0.67 when averaged over 20 patients who experienced 46 convulsive seizures. These promising results suggest that the proposed seizure detection system can be effectively used for long-term ambulatory seizure monitoring. Future steps include validating our findings in larger datasets and assessing the utility of detection for additional seizure types.