Semiautomated classification of nocturnal seizures using video recordings

Objective The objective of this study was to evaluate the accuracy of a semiautomated classification of nocturnal seizures using a hybrid system consisting of an artificial intelligence-based algorithm, which selects epochs with potential clinical relevance to be reviewed by human experts. Methods Consecutive patients with nocturnal motor seizures admitted for video-electroencephalographic long-term monitoring (LTM) were prospectively recruited. We determined the extent of data reduction by using the algorithm, and we evaluated the accuracy of seizure classification from the hybrid system compared with the gold standard of LTM. Results Forty consecutive patients (24 male; median age = 15 years) were analyzed. The algorithm reduced the duration of epochs to be reviewed to 14% of the total recording time (1874 h). There was a fair agreement beyond chance in seizure classification between the hybrid system and the gold standard (agreement coefficient = .33, 95% confidence interval = .20-.47). The hybrid system correctly identified all tonic-clonic and clonic seizures and 82% of focal motor seizures. However, there was low accuracy in identifying seizure types with more discrete or subtle motor phenomena. Significance Using a hybrid (algorithm-human) system for reviewing nocturnal video recordings significantly decreased the workload and provided accurate classification of major motor seizures (tonic-clonic, clonic, and focal motor seizures).