Seizure prediction has attracted growing attention as one of the most challenging predictive data analysis efforts to improve the life of patients with drug-resistant epilepsy and tonic seizures. Many outstanding studies have reported great results in providing sensible indirect (warning systems) or direct (interactive neural stimulation) control over refractory seizures, some of which achieved high performance. However, to achieve high sensitivity and a low false prediction rate, many of these studies relied on handcraft feature extraction and/or tailored feature extraction, which is performed for each patient independently. This approach, however, is not generalizable, and requires significant modifications for each new patient within a new dataset. In this article, we apply convolutional neural networks to different intracranial and scalp electroencephalogram (EEG) datasets and propose a generalized retrospective and patient-specific seizure prediction method. We use the short-time Fourier transform on 30-s EEG windows to extract information in both the frequency domain and the time domain. The algorithm automatically generates optimized features for each patient to best classify preictal and interictal segments. The method can be applied to any other patient from any dataset without the need for manual feature extraction. The proposed approach achieves sensitivity of 81.4%, 81.2%, and 75% and a false prediction rate of 0.06/h, 0.16/h, and 0.21/h on the Freiburg Hospital intracranial EEG dataset, the Boston Children's Hospital-MIT scalp EEG dataset, and the American Epilepsy Society Seizure Prediction Challenge dataset, respectively. Our prediction method is also statistically better than an unspecific random predictor for most of the patients in all three datasets.

Epilepsy is a common disorder characterized by recurrent seizures. An overwhelming majority of people with epilepsy regard the unpredictability of seizures as a major issue. More than 30 years of international effort have been devoted to the prediction of seizures, aiming to remove the burden of unpredictability and to couple novel, time-specific treatment to seizure prediction technology. A highly influential review published in 2007 concluded that insufficient evidence indicated that seizures could be predicted. Since then, several advances have been made, including successful prospective seizure prediction using intracranial EEG in a small number of people in a trial of a real-time seizure prediction device. In this Review, we examine advances in the field, including EEG databases, seizure prediction competitions, the prospective trial mentioned and advances in our understanding of the mechanisms of seizures. We argue that these advances, together with statistical evaluations, set the stage for a resurgence in efforts towards the development of seizure prediction methodologies. We propose new avenues of investigation involving a synergy between mechanisms, models, data, devices and algorithms and refine the existing guidelines for the development of seizure prediction technology to instigate development of a solution that removes the burden of the unpredictability of seizures.