Electroencephalography (EEG) is the gold standard for seizure detection. However, EEG systems are usually expensive and require well-trained technicians for data acquisition. Detection of seizures is important in patients with refractory epilepsy, especially when the seizure is prolonged and unwitnessed. Sudden unexpected death in epilepsy (SUDEP) is an important problem in patients with refractory epilepsy because the risk of SUDEP decreases the quality of life. There are several alternatives to EEG systems that are used to detect seizure-related pathophysiological changes. Measurements of heart rate and heart rate variability can be used to detect seizure-related cardiologic phenomena. Respiratory signals obtained based on respiration rate and respiratory chest and abdominal movements may also be used for seizure detection. Ictal movements can be detected using video analysis or wearable devices, such as accelerometers and gyroscopes. In addition, electrodermal activity (EDA) measurements are currently under investigation as a way to alert others to an ictal period. Although these technologies have limitations, they are affordable and easily wearable. They are thus appropriate for use in patients during daily activity. These devices may be potentially useful to detect the occurrence of unwitnessed seizures, and to increase the quality of life.
Diagnosis ; Electroencephalography ; Epilepsy ; Heart Rate ; Humans ; Quality of Life ; Respiratory Rate ; Seizures* ; Thorax

Background: and Purpose: Cerebral visual impairment (CVI) is an underdiagnosed condition in children, and its assessment tools have focused on older children. We aimed to develop a parental questionnaire for cerebral visual impairment (PQCVI) for screening CVI in young children. Methods: The PQCVI comprised 23 questions based on a modified version of Houliston and Dutton’s questionnaire for older children. The PQCVI with neurocognitive function tests was applied to 201 child–parent pairs with typically developing children younger than 72 months (age 32.4±20.1 months, mean±standard deviation). The children were classified into six age groups. The normative data, cutoff scores, and internal reliability were assessed and item analysis was performed. We referred to the total score for all questions as the cerebral visual function (CVF) score. Results: The normative data showed that the CVF score and the scores corresponding to ventral-stream and dorsal-stream visual functions plausibly increased with age. The scores rapidly reached 90% of their maximum values up to the age of 36 months, after which they increased slowly. Cronbach’s alpha for all questions across all age groups was 0.97, showing excellent consistency. The item difficulty and item discrimination coefficients showed that the questions were generally adequate for this age stage. Conclusions The PQCVI items produced reliable responses in children younger than 72 months. The rapid increase in scores before the age of 3 years supports the importance of early identification of CVI. Following additional clinical verification, the PQCVI may be useful for CVI screening.

Background: and Purpose: Cerebral visual impairment (CVI) is an underdiagnosed condition in children, and its assessment tools have focused on older children. We aimed to develop a parental questionnaire for cerebral visual impairment (PQCVI) for screening CVI in young children. Methods: The PQCVI comprised 23 questions based on a modified version of Houliston and Dutton’s questionnaire for older children. The PQCVI with neurocognitive function tests was applied to 201 child–parent pairs with typically developing children younger than 72 months (age 32.4±20.1 months, mean±standard deviation). The children were classified into six age groups. The normative data, cutoff scores, and internal reliability were assessed and item analysis was performed. We referred to the total score for all questions as the cerebral visual function (CVF) score. Results: The normative data showed that the CVF score and the scores corresponding to ventral-stream and dorsal-stream visual functions plausibly increased with age. The scores rapidly reached 90% of their maximum values up to the age of 36 months, after which they increased slowly. Cronbach’s alpha for all questions across all age groups was 0.97, showing excellent consistency. The item difficulty and item discrimination coefficients showed that the questions were generally adequate for this age stage. Conclusions The PQCVI items produced reliable responses in children younger than 72 months. The rapid increase in scores before the age of 3 years supports the importance of early identification of CVI. Following additional clinical verification, the PQCVI may be useful for CVI screening.