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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. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction.

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.

A total of 32 microwire electrodes were implanted bilaterally into the hippocampus of Sprague-Dawley rats, which were then stimulated in the manner prescribed for the chronic limbic epilepsy model. After the initial seizure brought on by the stimulation, the animals were recorded at a high sampling rate (approximately 12 kHz) for the entire duration of the latent period. Coherence was calculated across channels in both stimulated (and later seizing) animals and non-stimulated (and thus non-seizing control) animals. Average coherence over time was greatest in intrahemispherical electrode pairs in both stimulated and non-stimulated animals. However, the 200-800 Hz band displays increased coherence interhemispherically and up to 200 Hz band displays decreased coherence interhemispherically: this occurs only in stimulated animals.

Recently a number of groups [1,2] have reported on the existence of pathological High frequency oscillations (HFO's) (oscillations in the frequency range of 80–200 Hz, termed as Ripple band and oscillations in the frequency range of 200 Hz and above, termed as Fast Ripple band) in the epileptic brain both in in-vivo and in-vitro experiments. Our goal in this study is to study the statistical modulation of HFOs during epileptogenesis in order to characterize their function in progression to seizures in the epileptic brain. In this study we define a HFO event as a subset of wave having significant high frequency component with low wave amplitude. HFO are detected from data recorded at a sampling rate of 12000 Hz for the entire duration of epileptogenesis which lasts anywhere from about 3–6 weeks. Statistical analysis on the HFO suggest that occurrence of HFO's occur primarily during the 12 hour dark cycle whereas the HFO's primarily seem to occur during the 12 hour day cycle in the control rat The video recording shows that the rat is primarily in active and exploratory state during the dark cycle. These observations suggest that HFO in epileptic rats are correlated with the state of arousal. Spatial correlation of HFOs in different regions of the brain is also investigated with cross-correlogram. Comparison of cross-correlogram of the post-stimulus HFO in the epileptic rat to the pre stimulus HFO (control) suggests modification in the circuitry in the hippocampus, evidence for which in in-vitro experiments were provided by [3].