Beschreibung:
<jats:title>Summary</jats:title><jats:p>Our objective was to assess the clinical reliability of a wrist‐worn, wireless accelerometer sensor for detecting generalized tonic–clonic seizures (<jats:styled-content style="fixed-case">GTCS</jats:styled-content>). Seventy‐three consecutive patients (age 6–68 years; median 37 years) at risk of having <jats:styled-content style="fixed-case">GTCS</jats:styled-content> and who were admitted to the long‐term video–electroencephalography (<jats:styled-content style="fixed-case">EEG</jats:styled-content>) monitoring unit (<jats:styled-content style="fixed-case">LTM</jats:styled-content>) were recruited in three centers. The reference standard was considered the seizure time points identified by experienced clinical neurophysiologists, based on the video‐<jats:styled-content style="fixed-case">EEG</jats:styled-content> recordings and blinded to the accelerometer sensor data. Seizure time points detected real‐time by the sensor were compared with the reference standard. Patients were monitored for 17–171 h (mean 66.8; total 4,878). Thirty‐nine <jats:styled-content style="fixed-case">GTCS</jats:styled-content> were recorded in 20 patients. The device detected 35 seizures (89.7%). In 16 patients all seizures were detected. In three patients more than two thirds of the seizures were detected. The mean of the sensitivity calculated for each patient was 91%. The mean detection latency measured from the start of the focal seizure preceding the secondarily <jats:styled-content style="fixed-case">GTCS</jats:styled-content> was 55 s (95% confidence interval [<jats:styled-content style="fixed-case">CI</jats:styled-content>] 38–73 s). The rate of false alarms was 0.2/day. Our results suggest that the wireless wrist accelerometer sensor detects <jats:styled-content style="fixed-case">GTCS</jats:styled-content> with high sensitivity and specificity. Patients with <jats:styled-content style="fixed-case">GTCS</jats:styled-content> have an increased risk for injuries related to seizures and for sudden unexpected death in epilepsy (<jats:styled-content style="fixed-case">SUDEP</jats:styled-content>), and many nocturnal seizures remain undetected in unattended patients. A portable automatic seizure detection device will be an important tool for helping these patients.</jats:p>