Movement Patterns And Quantification Of Supplementary Motor Area Seizure

Video-EEG monitoring play a important role in diagnosis and differential diagnosis of paroxysmal diseases, frequency quantification of seizure, differential diagnosis of epileptic syndromes and presurgical assessment for it can be used to observe ictal behavior and ictal EEG,interictal and sleeping EEG. However, traditional Video-EEG monitoring be limited in observing ictal semiology by eyes, which can not be used for quantifications. This observing method is subjective which indicate that different doctors with different experience will gain different information if they use this method. Secondly, this method can not be used in analyzing the amplitude and frequency of movement seizures. This research employ image analysis software developed by life science institute of electronic science and technology university to trace the movement patterns and to analyze the quantification of supplementary motor area(SMA) seizures. Objective 1) To develop a quantification system of seizure and to provide a new method for the research of epileptic semiology; 2) To develop movement patterns of supplementary motor seizures. Method SMA seizure consists of four types of seizure, which are hypermotor automatism, posturing tonic seizure, fencing posture seizure and versive seizure. We collect 10 times of ictal video for every type of seizure and turn them into matrix with image analysis software developed by life science institute of electronic science and technology university. Then we turn the matrix into plot with the software named MATLAB 6.5 edition and get two movement trace one on X axis and the other on Y axis. To compare the relationship between the distal end movement and proximal end movement of extremities, we divide the amplitude of distal movement by that of proximal end movement and get the ratio named distal end to proximal end ratio (DPR). If the absolute value of the ratio more than 3, which indicate that the extremity movement is proximal end movement, otherwise the movement is distal end movement.To compare the extent of difference between shoulder movement and abdomen movement, we divide the amplitude of shoulder movement by that of abdomen movement named shoulder to abdomen ratio (SAR). The ratio is more close to 1, the extent of difference more small. If the absolute value of the ratio is more than 1, it refer to the movement of shoulder is more than abdomen movement. Furthermore, we compare these indexes between temporal epilepsy, pseudoseizure and hypermotor seizure. Result 1) hypermotor seizure is high amplitude movement especial in extremities movement. The average amplitude of head, trunk and extremities are more than 30 pixels and the frequency is about 1 Hz. In common, the absolute value of DPR is less than 3, which demonstrate that extremities movement is proximal end movement. The fluctuation of SAR is high, which illustrate that trunk movement is confused. 2)The movement trace of posturing tonic seizure has the same characteristics as that of fencing posture, which is that the movement trace of involved extremities slowly increases or decreases.There absolute of DPR less than 3 at first and more than 3 at last, which indicate that the movement is proximal end movement at the initial stage and later it turn into distal end movement. There absolute of SAR are less than 1,which indicate that the amplitude of shoulder movement is less than abdomen movement. 3) The movement trace of versive seizure has the characteristics that the traces of involved positions increases or decreases gradually, and there speed of increase or decrease is uneven. The absolute of DPR are less than 3 in general, which refer to the movement is proximal end movement. The absolute of SAR are more than 1, which indicate that the amplitude shoulder movement is more than abdomen movement. At last we compare these indexes between temporal epilepsy, pseudoseizure and hypermotor seizure with the method of one-way ANOVA. We find that the difference between hypermotor seizure and temporal seizure and pseudoseizure has statistical significance, which demonstrates that our quantification system of seizure play a significant role in differential diagnosis. Conclusion 1) This research illustrate that quantification of epileptic motor seizure is feasible. 2) SMA seizure has its own characteristics in movement trace and quantification indexes, which represent that this quantification system is important in diagnosis of epilepsy. 3) According to compare the difference of quantification indexes between hypermotor seizure and temporal seizure and pseudoseizure, we can come to the conclusion that quantification analysis system of this research possesses significance.