A rule-based seizure prediction method for focal neocortical epilepsy

Objective: In the present study, we have developed a novel patient-specific rule-based seizure prediction system for focal neocortical epilepsy. Methods: Five univariate measures including correlation dimension, correlation entropy, noise level, Lempel-Ziv complexity, and largest Lyapunov exponent as well as one bivariate measure, nonlinear interdependence, were extracted from non-overlapping 10-s segments of intracranial electroencephalogram (iEEG) data recorded using electrodes implanted deep in the brain and/or placed on the cortical surface. The spatio-temporal information was then integrated by using rules established based on patient-specific changes observed in the period prior to a seizure sample for each patient. The system was tested on 316. h of iEEG data containing 49 seizures recorded in 11 patients with medically intractable focal neocortical epilepsy. Results: For seizure occurrence periods of 30 and 50. min our method showed an average sensitivity of 79.9% and 90.2% with an average false prediction rate of 0.17 and 0.11/h, respectively. In terms of sensitivity and false prediction rate, the system showed superiority to random and periodical predictors. Conclusions: The nonlinear analysis of iEEG in the period prior to seizures revealed patient-specific spatio-temporal changes that were significantly different from those observed within baselines in the majority of the seizures analyzed in this study. Significance: The present results suggest that the patient specific rule-based approach may become a potentially useful approach for predicting seizures prior to onset.