Automatic seizure detection in long-term scalp EEG using an adaptive thresholding technique: A validation study for clinical routine

•An automatic seizure detection method for long-term scalp EEG recordings was validated under routine conditions in a large number of unselected epilepsy patients with various seizure types and epilepsy syndromes.•The analysis was performed in a standardized fashion for all patients and all EEG data requiring no adjustment of parameters.•The seizure detection algorithm provided high values for sensitivity and a low number of false positive events demonstrating its applicability in clinical practise.

ObjectiveIn a previous study we proposed a robust method for automatic seizure detection in scalp EEG recordings. The goal of the current study was to validate an improved algorithm in a much larger group of patients in order to show its general applicability in clinical routine.MethodsFor the detection of seizures we developed an algorithm based on Short Time Fourier Transform, calculating the integrated power in the frequency band 2.5–12 Hz for a multi-channel seizure detection montage referenced against the average of Fz-Cz-Pz. For identification of seizures an adaptive thresholding technique was applied. Complete data sets of each patient were used for analyses for a fixed set of parameters.Results159 patients (117 temporal-lobe epilepsies (TLE), 35 extra-temporal lobe epilepsies (ETLE), 7 other) were included with a total of 25,278 h of EEG data, 794 seizures were analyzed. The sensitivity was 87.3% and number of false detections per hour (FpH) was 0.22/h. The sensitivity for TLE patients was 89.9% and FpH = 0.19/h; for ETLE patients sensitivity was 77.4% and FpH = 0.25/h.ConclusionsThe seizure detection algorithm provided high values for sensitivity and selectivity for unselected large EEG data sets without a priori assumptions of seizure patterns.SignificanceThe algorithm is a valuable tool for fast and effective screening of long-term scalp EEG recordings.