In-depth performance analysis of an EEG based neonatal seizure detection algorithm

Clin Neurophysiol. 2016 May;127(5):2246-56. doi: 10.1016/j.clinph.2016.01.026. Epub 2016 Feb 21.


Objective: To describe a novel neurophysiology based performance analysis of automated seizure detection algorithms for neonatal EEG to characterize features of detected and non-detected seizures and causes of false detections to identify areas for algorithmic improvement.

Methods: EEGs of 20 term neonates were recorded (10 seizure, 10 non-seizure). Seizures were annotated by an expert and characterized using a novel set of 10 criteria. ANSeR seizure detection algorithm (SDA) seizure annotations were compared to the expert to derive detected and non-detected seizures at three SDA sensitivity thresholds. Differences in seizure characteristics between groups were compared using univariate and multivariate analysis. False detections were characterized.

Results: The expert detected 421 seizures. The SDA at thresholds 0.4, 0.5, 0.6 detected 60%, 54% and 45% of seizures. At all thresholds, multivariate analyses demonstrated that the odds of detecting seizure increased with 4 criteria: seizure amplitude, duration, rhythmicity and number of EEG channels involved at seizure peak. Major causes of false detections included respiration and sweat artefacts or a highly rhythmic background, often during intermediate sleep.

Conclusion: This rigorous analysis allows estimation of how key seizure features are exploited by SDAs.

Significance: This study resulted in a beta version of ANSeR with significantly improved performance.

Keywords: Automated seizure detection; Neonatal seizures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / physiopathology*
  • Brain / physiopathology*
  • Diagnosis, Computer-Assisted
  • Electroencephalography
  • Female
  • Humans
  • Hypoxia, Brain / complications
  • Hypoxia, Brain / physiopathology*
  • Infant, Newborn
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / physiopathology*
  • Male
  • Meconium Aspiration Syndrome / complications
  • Meconium Aspiration Syndrome / physiopathology*
  • Seizures / diagnosis*
  • Seizures / etiology
  • Seizures / physiopathology