Detecting, quantifying, and/or classifying seizures using multimodal data

• US 10,405,792 B2
• Filed: 12/21/2016
• Issued: 09/10/2019
• Est. Priority Date: 10/01/2010
• Status: Active Grant

• Current Assignee: Flint Hills Scientific, LLC
• Original Assignee: Flint Hills Scientific, LLC
• Inventors: Osorio, Ivan
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US15/387,417
• Publication Number:
  US 20170150916A1
• Time in Patent Office: 993 Days
• Field of Search: None
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/0531 Measuring skin impedance
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1117 Fall detection
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/4266 sweat secretion
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• CPC Class Codes: A61N 1/36064 : Epilepsy
• CPC Class Codes: A61N 1/36135 : using physiological parameters
• CPC Class Codes: A61N 1/36139 : with automatic adjustment
• CPC Class Codes: A61N 1/36585 : controlled by two or more physical parameters
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method, comprising receiving at least one of a signal relating to a first cardiac activity and a signal relating to a first body movement from a patient; triggering at least one of a test of the patient'"'"'s responsiveness, awareness, a second cardiac activity, a second body movement, a spectral analysis test of the second cardiac activity, and a spectral analysis test of the second body movement, based on at least one of the signal relating to the first cardiac activity and the signal relating to the first body movement; determining an occurrence of an epileptic event based at least in part on said one or more triggered tests; and performing a further action in response to said determination of said occurrence of said epileptic event. Further methods allow classification of epileptic events. Apparatus and systems capable of implementing the method.

Claims

1. A method, comprising:

receiving via one or more processors of a medical device a signal indicative of a patient'"'"'s dermal activity;

receiving via the one or more processors of the medical device at least one of a kinetic signal indicative of a patient'"'"'s kinetic activity and a cardiac signal indicative of a patient'"'"'s cardiac activity;

determining via the one or more processors of the medical device a dermal activity and a dermal activity feature from the signal indicative of the patient'"'"'s dermal activity, and determining at least one of a kinetic feature from the kinetic signal and a cardiac feature from the cardiac signal;

detecting via the one or more processors of the medical device an impending clinical onset of an epileptic seizure based on a change in the dermal activity and at least one of the kinetic feature and the cardiac feature indicative of the impending clinical onset of the epileptic seizure;

performing a further action in response to the detection of the impending clinical onset of the epileptic seizure; and

classifying an occurrence of the epileptic seizure, based at least in part on the change in the dermal activity feature, the patient'"'"'s cardiac activity, and the patient'"'"'s kinetic activity.

2. The method of claim 1, wherein the further action comprises one or more of logging an occurrence of the clinical onset of the epileptic seizure;

logging a time of the occurrence of the clinical onset of the epileptic seizure;

logging a date of the occurrence of the clinical onset of the epileptic seizure;

providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider;

providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the epileptic seizure;

assessing at least one of an awareness or responsiveness of the patient during the epileptic seizure;

assessing the severity of the epileptic seizure;

determining an end of the epileptic seizure;

determining a beginning of a post-ictal period;

determining an end of the post-ictal period; and

assessing a patient'"'"'s post-ictal impairment or recovery from the epileptic seizure.

3. The method of claim 1, wherein the patient'"'"'s cardiac activity is heart rate, a heart rate variability, or a heart beat morphology.

4. The method of claim 1, wherein the signal indicative of the patient'"'"'s cardiac activity is provided by at least one of an electrocardiogram (EKG) signal, a phonocardiogram (PKG) signal, an apexcardiography signal, a blood pressure signal, and an echocardiography signal.

5. The method of claim 1, wherein the signal indicative of the patient'"'"'s kinetic activity is provided by at least one of an accelerometer, an inclinometer, an actigraph, an imaging system, a dynamometer, a gyroscope, or an electromyogram (EMG).

6. The method of claim 1, wherein the signal indicative of the patient'"'"'s dermal activity is provided by at least one of a skin resistance sensor, a skin temperature sensor, a skin blood flow sensor, or a skin sweat gland activity sensor.

7. The method of claim 1, further comprising classifying an epileptic event based upon at least one of the patient'"'"'s cardiac activity, body movement data, or the patient'"'"'s dermal activity.

8. A method, comprising:

receiving via one or more processors of a medical device at least one of a kinetic signal indicative of a patient'"'"'s kinetic activity and a cardiac signal indicative of a patient'"'"'s cardiac activity;

determining via the one or more processors of medical device at least one of a kinetic feature from the kinetic signal and a cardiac feature from the cardiac signal;

detecting via the one or more processors of the medical device a clinical onset of an epileptic seizure based on the at least one of a change in one kinetic feature occurring after the cardiac feature;

classifying an occurrence of the epileptic seizure, based at least in part on the kinetic feature or the cardiac feature; and

performing a further action in response to at least one of;

a detection of an impending clinical epileptic seizure and the onset of the clinical epileptic seizure.

9. The method of claim 8, further comprising:

performing a further action in response to the detection of the impending clinical epileptic seizure or the onset of the clinical epileptic seizure, wherein the further action comprises one or more of;

logging an occurrence of the onset of the clinical epileptic seizure;

logging a time of the occurrence of the onset of the clinical epileptic seizure;

logging a date of the occurrence of the onset of the clinical epileptic seizure;

providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider;

providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the epileptic seizure;

assessing at least one of an awareness or responsiveness of the patient during the epileptic seizure;

assessing the severity of the epileptic seizure;

determining an end of the epileptic seizure;

determining a beginning of a post-ictal period;

determining an end of the post-ictal period; and

assessing a patient'"'"'s post-ictal impairment or recovery from the epileptic seizure.

10. The method of claim 8, further comprising:

performing a further action in response to the classification, wherein the further action comprises one or more of;

logging an occurrence of the classified epileptic seizure;

logging a time of the occurrence of the classified epileptic seizure;

logging a date of the occurrence of the classified epileptic seizure;

providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider;

providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the classified epileptic seizure;

assessing at least one of an awareness or responsiveness of the patient during the classified epileptic seizure;

assessing the severity of the classified epileptic seizure;

determining an end of the classified epileptic seizure;

determining a beginning of a post-ictal period;

determining an end of the post-ictal period; and

assessing a patient'"'"'s post-ictal impairment or recovery from the classified epileptic seizure.

11. The method of claim 8, wherein the patient'"'"'s cardiac activity is heart rate, a heart rate variability, or a heart beat morphology.

12. The method of claim 8, wherein the signal indicative of the patient'"'"'s cardiac activity is provided by at least one of an electrocardiogram (EKG) signal, a phonocardiogram (PKG) signal, an apexcardiography signal, a blood pressure signal, and an echocardiography signal.

13. The method of claim 8, wherein the signal indicative of the patient'"'"'s kinetic activity is provided by at least one of an accelerometer, an inclinometer, an actigraph, an imaging system, a dynamometer, a gyroscope, or an electromyogram (EMG).

14. The method of claim 8, wherein classifying an epileptic event is based upon at least one of the patient'"'"'s cardiac activity or body movement data.

15. A system, comprising:

at least one first sensor configured to receive a signal relating to a dermal activity from a patient,

at least one second sensor configured to receive at least one of a signal relating to a cardiac activity from the patient or a signal relating to a body movement from the patient,

a feature determination unit configured to determine a dermal activity feature from the signal relating to the dermal activity, and at least one of a cardiac activity feature from the signal relating to the cardiac activity and a kinetic activity feature from the signal relating to the kinetic activity,

a detection unit configured to receive the dermal activity feature, and at least one of the cardiac activity feature and the kinetic activity feature, from the feature determination unit and determine an impending clinical onset of an epileptic seizure based upon the received activity features; and

an action unit configured to receive an indication of an occurrence of the epileptic seizure from the detection unit and perform an assessment of an awareness or responsiveness of the patient during the epileptic seizure and at least one of;

logging the occurrence of the epileptic seizure;

logging a time of the occurrence of the epileptic seizure;

logging a date of the occurrence of the epileptic seizure;

providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider;

providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the epileptic seizure;

assessing the severity of the epileptic seizure;

determining an end of the epileptic seizure;

determining a beginning of a post-ictal period;

determining an end of the post-ictal period; and

assessing a patient'"'"'s post-ictal impairment or recovery from the epileptic seizure.

16. The system of claim 15, further comprising a spectral analysis unit configured to generate at least one spectral analysis signal from at least one of a signal relating to a second cardiac activity and a signal relating to a second body movement;

and wherein the detection unit is further configured to receive the at least one spectral analysis signal from the spectral analysis unit.

17. The system of claim 15, wherein the at least one second sensor is selected from an electrocardiogram (EKG) sensor, a phonocardiogram (PKG) sensor, an apexcardiography sensor, a blood pressure sensor, or an echocardiography sensor.

18. The system of claim 15, wherein the at least one second sensor is selected from an accelerometer sensor, an inclinometer sensor, an actigraph sensor, an imaging system sensor, a dynamometer sensor, a gyroscope sensor, or an electromyogram (EMG) sensor.

19. The system of claim 15, wherein the at least one first sensor is selected from a skin resistance sensor, a skin temperature sensor, a skin blood flow sensor, or a skin sweat gland activity sensor.