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Lookup NU author(s): Sarah Gascoigne, Dr Gabrielle SchroederORCiD, Dr Mariella Panagiotopoulou, Dr Jessica Blickwedel, Christoforos Papasavvas, Dr Rhys ThomasORCiD, Professor Kevin Wilson, Professor Peter TaylorORCiD, Professor Yujiang WangORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.Objective: Understanding fluctuations in seizure severity within individuals is important for determining treatment outcomes and responses to therapy, as well as assessing novel treatments for epilepsy. Current methods for grading seizure severity rely on qualitative interpretations from patients and clinicians. Quantitative measures of seizure severity would complement existing approaches to electroencephalographic (EEG) monitoring, outcome monitoring, and seizure prediction. Therefore, we developed a library of quantitative EEG markers that assess the spread and intensity of abnormal electrical activity during and after seizures. Methods: We analyzed intracranial EEG (iEEG) recordings of 1009 seizures from 63 patients. For each seizure, we computed 16 markers of seizure severity that capture the signal magnitude, spread, duration, and postictal suppression of seizures. Results: Quantitative EEG markers of seizure severity distinguished focal versus subclinical seizures across patients. In individual patients, 53% had a moderate to large difference (rank sum (Formula presented.), (Formula presented.)) between focal and subclinical seizures in three or more markers. Circadian and longer term changes in severity were found for the majority of patients. Significance: We demonstrate the feasibility of using quantitative iEEG markers to measure seizure severity. Our quantitative markers distinguish between seizure types and are therefore sensitive to established qualitative differences in seizure severity. Our results also suggest that seizure severity is modulated over different timescales. We envisage that our proposed seizure severity library will be expanded and updated in collaboration with the epilepsy research community to include more measures and modalities.
Author(s): Gascoigne SJ, Waldmann L, Schroeder GM, Panagiotopoulou M, Blickwedel J, Chowdhury F, Cronie A, Diehl B, Duncan JS, Falconer J, Faulder R, Guan Y, Leach V, Livingstone S, Papasavvas C, Thomas RH, Wilson K, Taylor PN, Wang Y
Publication type: Article
Publication status: Published
Journal: Epilepsia
Year: 2023
Volume: 64
Issue: 4
Pages: 1074-1086
Print publication date: 01/04/2023
Online publication date: 02/02/2023
Acceptance date: 31/01/2023
Date deposited: 06/03/2023
ISSN (print): 0013-9580
ISSN (electronic): 1528-1167
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/epi.17525
DOI: 10.1111/epi.17525
PubMed id: 36727552
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