Monitoring burst suppression in critically ill patients: Multi-centric evaluation of a novel method.

OBJECTIVE: To develop a computational method to detect and quantify burst suppression patterns (BSP) in the EEGs of critical care patients. A multi-center validation study was performed to assess the detection performance of the method. METHODS: The fully automatic method scans the EEG for discontinuous patterns and shows detected BSP and quantitative information on a trending display in real-time. The method is designed to work without setting any patient specific parameters and to be insensitive to EEG artifacts and periodic patterns. For validation a total of 3982 h of EEG from 88 patients were analyzed from three centers. Each EEG was annotated by two reviewers to assess the detection performance and the inter-rater agreement. RESULTS: Average inter-rater agreement between pairs of reviewers was κ=0.69. On average 22% of the review segments included BSP. An average sensitivity of 90% and a specificity of 84% were measured on the consensus annotations of two reviewers. More than 95% of the periodic patterns in the EEGs were correctly suppressed. CONCLUSION: A fully automatic method to detect burst suppression patterns was assessed in a multi-center study. The method showed high sensitivity and specificity. SIGNIFICANCE: Clinically applicable burst suppression detection method validated in a large multi-center study.

Spatial correlation based artifact detection for automatic seizure detection in EEG.

Automatic EEG-processing systems such as seizure detection systems are more and more in use to cope with the large amount of data that arises from long-term EEG-monitorings. Since artifacts occur very often during the recordings and disturb the EEG-processing, it is crucial for these systems to have a good automatic artifact detection. We present a novel, computationally inexpensive automatic artifact detection system that uses the spatial distribution of the EEG-signal and the location of the electrodes to detect artifacts on electrodes. The algorithm was evaluated by including it into the automatic seizure detection system EpiScan and applying it to a very large amount of data including a large variety of EEGs and artifacts.

EpiScan: online seizure detection for epilepsy monitoring units.

An online seizure detection algorithm for long-term EEG monitoring is presented, which is based on a periodic waveform analysis detecting rhythmic EEG patterns and an adaptation module automatically adjusting the algorithm to patient-specific EEG properties. The algorithm was evaluated using 4.300 hours of unselected EEG recordings from 48 patients with temporal lobe epilepsy. For 66% of the patients the algorithm detected 100% of the seizures. A mean sensitivity of 83% was achieved. An average of 7.2 false alarms within 24 hours for unselected EEG makes the algorithm attractive for epilepsy monitoring units.