Sensitivity of a seizure activity detection computer in childhood video/electroencephalographic monitoring

Purpose: Few data describe the sensitivity of a ''Seizure Activity Detection Computer'' (SzAC) in childhood video/EEG (VEEG) monitoring, especially for very young children. We examined the accuracy of SzAC in childhood VEEG monitoring in different pediatric age groups. Methods: We visually analyzed VEEG monitoring samples for randomly designated subsets of 56 patients with childhood epilepsy, reviewing 335 visually detected electrographic seizures to analyze the sensitivity of SzAC for each age group as well as the electrographic characteristics affecting the sensitivity of automated computer-based seizure detection. Results: SzAC was positive in 227 of 335 (67.8%) visually identified electrographic seizures in the entire study group. The SzAC sensitivity for infants (age 2 months to 2 years) was 59.7% (43 of 72 seizures); for young children (age 3-10 years), sensitivity 56.5% (91 of 161 seizures). In adolescents (age 11-18 years), SzAC was positive in 93 of 102 (91.2%) seizures-i.e., in a significantly greater number of seizures than in younger age groups. SzAC was significantly less sensitive in detecting electrographic seizures characterized as being of short duration or of low voltage. Conclusions: The overall sensitivity of SzAC in detecting childhood electrographic seizures was 67.8%. The sensitivity was significantly less in younger age groups as compared with that in children aged >11 years. Electrographic seizures of relatively short duration or low voltage were often missed by SzAC.