Epilepsy, one of the most common neurological diseases, affects over 50 million people worldwide. Epilepsy can have a broad spectrum of debilitating medical and social consequences. Although antiepileptic drugs have helped treat millions of patients, roughly a third of all patients have seizures that are refractory to pharmacological intervention. The evolution of our understanding of this dynamic disease leads to new treatment possibilities. There is great interest in the development of devices that incorporate algorithms capable of detecting early onset of seizures or even predicting them hours before they occur. The lead time provided by these new technologies will allow for new types of interventional treatment. In the near future, seizures may be detected and aborted before physical manifestations begin. In this chapter we discuss the algorithms that make these devices possible and how they have been implemented to date. We also compare and contrast these measures, and review their individual strengths and weaknesses. Finally, we illustrate how these techniques can be combined in a closed-loop seizure prevention system.

We compare the performance of three support vector machine (SVM) types: weighted SVM, one-class SVM and support vector data description (SVDD) for the application of seizure detection in an animal model of chronic epilepsy. Large EEG datasets (273 h and 91 h respectively, with a sampling rate of 1 kHz) from two groups of rats with chronic epilepsy were used in this study. For each of these EEG datasets, we extracted three energy-based seizure detection features: mean energy, mean curve length and wavelet energy. Using these features we performed twofold cross-validation to obtain the performance statistics: sensitivity (S), specificity (K) and detection latency (tau) as a function of control parameters for the given SVM. Optimal control parameters for each SVM type that produced the best seizure detection statistics were then identified using two independent strategies. Performance of each SVM type is ranked based on the overall seizure detection performance through an optimality index metric (O). We found that SVDD not only performed better than the other SVM types in terms of highest value of the mean optimality index metric (O⁻) but also gave a more reliable performance across the two EEG datasets.

The performance of five non-parametric, univariate seizure detection schemes (embedding delay, Hurst scale, wavelet scale, nonlinear autocorrelation and variance energy) were evaluated as a function of the sampling rate of EEG recordings, the electrode types used for EEG acquisition, and the spatial location of the EEG electrodes in order to determine the applicability of the measures in real-time closed-loop seizure intervention. The criteria chosen for evaluating the performance were high statistical robustness (as determined through the sensitivity and the specificity of a given measure in detecting a seizure) and the lag in seizure detection with respect to the seizure onset time (as determined by visual inspection of the EEG signal by a trained epileptologist). An optimality index was designed to evaluate the overall performance of each measure. For the EEG data recorded with microwire electrode array at a sampling rate of 12 kHz, the wavelet scale measure exhibited better overall performance in terms of its ability to detect a seizure with high optimality index value and high statistics in terms of sensitivity and specificity.