A novel wavelet-based algorithm for real-time detection of epileptic seizures using scalp EEG is proposed. In a moving-window analysis, the EEG from each channel is decomposed by wavelet packet transform. Using wavelet coefficients from seizure and nonseizure references, a patient-specific measure is developed to quantify the separation between seizure and nonseizure states for the frequency range of 1-30 Hz. Utilizing this measure, a frequency band representing the maximum separation between the two states is determined and employed to develop a normalized index, called combined seizure index (CSI). CSI is derived for each epoch of every EEG channel based on both rhythmicity and relative energy of that epoch as well as consistency among different channels. Increasing significantly during ictal states, CSI is inspected using one-sided cumulative sum test to generate proper channel alarms. Analyzing alarms from all channels, a seizure alarm is finally generated. The algorithm was tested on scalp EEG recordings from 14 patients, totaling approximately 75.8 h with 63 seizures. Results revealed a high sensitivity of 90.5%, a false detection rate of 0.51 h(-1) and a median detection delay of 7 s. The algorithm could also lateralize the focus side for patients with temporal lobe epilepsy.

A novel patient-specific seizure prediction method based on the analysis of positive zero-crossing intervals in scalp electroencephalogram (EEG) is proposed. In a moving-window analysis, the histogram of these intervals for the current EEG epoch is computed, and the values corresponding to specific bins are selected as an observation. Then, the set of observations from the last 5 min is compared with two reference sets of data points (preictal and interictal) through novel measures of similarity and dissimilarity based on a variational Bayesian Gaussian mixture model of the data. A combined index is then computed and compared with a patient-specific threshold, resulting in a cumulative measure which is utilized to form an alarm sequence for each channel. Finally, this channel-based information is used to generate a seizure prediction alarm. The proposed method was evaluated using ∼ 561 h of scalp EEG including a total of 86 seizures in 20 patients. A high sensitivity of 88.34 % was achieved with a false prediction rate of 0.155 h⁻¹ and an average prediction time of 22.5 min for the test dataset. The proposed method was also tested against a Poisson-based random predictor.

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