Novel Smartphone-Based Screening Tool for Absence Seizures in Pediatric Settings: A Comparative Study With Video EEG
Rachel Kuperman1, Nathaniel J Blanco1, Jeffrey Buchhalter2
1Eysz, Berkeley, California.
Insights
The Eysz HV Recorder accurately screens for absence seizures in children, improving diagnosis and reducing misdiagnosis of conditions like ADHD. This tool aids in differentiating epileptic from nonepileptic staring spells.
Area of Science:
- Pediatric Neurology
- Medical Technology
- Diagnostic Tools
Background:
- Staring spells are a common pediatric concern, often leading to diagnostic challenges and misdiagnosis, such as Childhood Absence Epilepsy being mistaken for ADHD.
- Hyperventilation (HV) is a key diagnostic method for absence seizures, but traditional methods can be cumbersome.
Purpose of the Study:
- To evaluate the Eysz HV Recorder, a smartphone-based device, as a screening tool for absence seizures in children.
- To assess the accuracy of the HV Recorder in capturing and diagnosing absence seizures during hyperventilation.
Main Methods:
- Sixty pediatric participants underwent hyperventilation (HV) using the HV Recorder during electroencephalography (EEG).
- Two independent panels of epileptologists reviewed video electroencephalography (vEEG) and HV Recorder videos in a blinded manner.
- The study compared the diagnostic performance of HV Recorder reviewers against vEEG reviews.
Main Results:
- The HV Recorder demonstrated 100% sensitivity and 91% specificity for detecting absence seizures lasting ≥7 seconds.
- Individual seizures were detected with 96% sensitivity (≥7s) and 86% (all lengths).
- Epileptologists showed high agreement when reviewing both vEEG and HV Recorder data, with clearer identification of events from the HV Recorder video.
Conclusions:
- The Eysz HV Recorder is a highly sensitive and specific tool for identifying absence seizures.
- This technology can assist clinicians in distinguishing between epileptic and nonepileptic staring spells, potentially reducing unnecessary referrals and misdiagnoses.
Background:
Staring spells, a common chief complaint in pediatrics, lead to both over-referral and under-referral to neurologists, creating significant challenges in clinical care. Children with nonepileptic staring episodes are frequently referred unnecessarily to neurology, while children with Childhood Absence Epilepsy are commonly misdiagnosed with disorders such as attention-deficit/hyperactivity disorder (ADHD). Hyperventilation (HV) has long been used as a neurobehavioral tool to provoke and diagnose absence seizures in children with suspected Childhood Absence Epilepsy. We evaluated the Eysz HV Recorder, a smartphone-based tool that guides children through HV while capturing video, as a screening tool for absence seizures.
Methods:
Sixty participants underwent HV using the HV Recorder during electroencephalography observation. Two independent, blinded panels of three epileptologists each reviewed the data as follows: one panel reviewed the video electroencephalography (vEEG) and the other reviewed the HV Recorder video. We assessed the HV Recorder reviewers' ability to detect seizures compared to the vEEG reviews.
Results:
HV Recorder reviewers had 100% sensitivity and 91% specificity for identifying absence seizing patients with seizures ≥7 s. Individual seizures were detected with 96% sensitivity for seizures ≥7s and 86% across seizures of all lengths. Agreement levels were similar between epileptologists reviewing the vEEG and the HV Recorder video (vEEG-vEEG: 90%, HV-HV: 87%, HV-vEEG: 82%). Reviewers reported they could clearly identify clinical events from the HV Recorder video more often than the vEEG video.
Conclusions:
The Eysz HV Recorder is an accurate tool with high sensitivity and specificity for identifying absence seizures, which could aid clinicians in differentiating epileptic from nonepileptic staring spells.
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