SEIZURE DETECTION BASED ON WORK LEVEL EXCURSION

• US 20140275831A1
• Filed: 01/30/2014
• Published: 09/18/2014
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: Flint Hills Scientific, LLC
• Original Assignee: Flint Hills Scientific, LLC
• Inventors: Osorio, Ivan
• Granted Patent: US 9,788,779 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/4866 Evaluating metabolism A61B5/083 takes precedence

Abstract

We report a method of determining an occurrence of an epileptic convulsive seizure in a patient, comprising: receiving body data from a patient during a first time period, determining a work level relating to said first time period at least based partially upon said body data; determining whether said work level exceeds an extreme work level threshold; performing a responsive action, in response to a determination that said work level exceeds said extreme work level threshold. We also report a medical device system configured to implement the method. We also report a non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform the method.

Claims

1. A non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform a method of determining an occurrence of an epileptic convulsive seizure in a patient, comprising:

receiving body data from a patient during a first time period,

determining a work level relating to said first time period at least based partially upon said body data;

determining whether said work level exceeds an extreme work level threshold;

detecting said extreme event in the patient responsive to determining that said work level exceeds said extreme work level threshold;

classifying said extreme event as an epileptic convulsive seizure;

performing a responsive action comprising;

issuing a warning of said detection;

delivering a therapy;

determining a severity of said detection of the epileptic convulsive seizure; and

logging to memory one or more of;

at least one of a date, a time, or a severity of said detected epileptic convulsive seizure;

a type of therapy delivered to treat said epileptic convulsive seizure;

or

at least one effect of a therapy delivered to treat the epileptic convulsive seizure.

2. The non-transitory computer readable program storage unit of claim 1, wherein said body data comprises at least one of kinetic data, heart rate, oxygen saturation data, blood pH data, oxygen consumption data, glucose consumption data, respiratory rate, tidal volume, or end tidal CO₂ data.

3. The non-transitory computer readable program storage unit of claim 1, further comprising determining said extreme work level threshold based on historical work level data for the patient.

4. The non-transitory computer readable program storage unit of claim 1, further comprising dynamically adjusting said extreme work level threshold, based at least in part on one or more of a time of day, environmental conditions, a patient'"'"'s body weight and height, a patient'"'"'s body mass index, a patient'"'"'s gender, a patient'"'"'s age, an indicator of said patient'"'"'s overall health, or an indicator of said patient'"'"'s overall fitness.

5. The non-transitory computer readable program storage unit of claim 1, wherein determining said extreme work level threshold comprises determining said extreme work level threshold based at least partially upon historical indication of the patient'"'"'s maximal non-pathological work level.

6. The non-transitory computer readable program storage unit of claim 1, further comprising implementing a confirmation test of said epileptic seizure in response to said work level exceeding said extreme work level threshold, and confirming said occurrence of said epileptic seizure based at least in part on a result of said confirmation test.

7. A medical device, comprising:

a body data module configured to receive body data;

a work level data module configured to determine a first patient work level during a first time period, and a second patient work level during a second time period;

a work level excursion module configured to;

determine whether said second work level exceeds said first work level by an amount greater than a first work level excursion threshold; and

detect a work level excursion based upon a determination that said second work level exceeds said first work level by an amount greater than said first work level excursion threshold; and

a controller to perform at least one of warning of said work level excursion, providing a therapy for said work level excursion, or logging an occurrence of said work level excursion, in response to detecting said work level excursion.

8. The medical device of claim 7, wherein the first time period is at a first time of day on a current day and the second time period is at the first time of day on at least one prior day.

9. The medical device of claim 7, wherein the first time period and the second time period are contiguous, partially overlapping, or fully overlapping.

10. The medical device of claim 7, wherein the first patient work level and the second patient work level are each a work level magnitude or a work level rate of change.

11. The medical device of claim 7, further comprising:

at least one sensor, each configured to collect at least one body signal from a patient relating to a work level of said patient.

12. The medical device of claim 11, wherein said at least one sensor comprises at least one of:

an autonomic data acquisition unit configured to acquire at least one of heart beat data, blood pressure data, respiration data, or blood gas data;

a neurological data acquisition unit configured to acquire kinetic data selected from the group consisting of accelerometer data and inclinometer data.

an endocrine data acquisition unit configured to acquire endocrine data,

a metabolic data acquisition unit configured to acquire metabolic data;

a tissue stress marker data acquisition unit configured to acquire tissue stress marker data;

or

a physical fitness data acquisition unit configured to acquire data relating to the patient'"'"'s physical fitness.

13. The medical device of claim 7, further comprising a patient state data unit configured to determine the patient state based upon said body data.

14. The medical device of claim 7, wherein said medical device is configured to confirm said pathological state based on at least one of cardiac data of said patient, kinetic data of said patient, the patient'"'"'s responsiveness, or a patient'"'"'s awareness.

15. The medical device of claim 7, wherein said work level excursion threshold is based at least in part on one or more of a time of day, an environmental condition, an indicator of said patient'"'"'s overall health, an indicator of said patient'"'"'s hydration status, an indicator of said patient'"'"'s overall fitness, said patient'"'"'s body weight and height, said patient'"'"'s body mass index, said patient'"'"'s gender, or said patient'"'"'s age.

16. The medical device of claim 7, wherein said work level data module comprises:

a body data analysis module to determine a value relating to at least one of a cardiac data, blood pressure data, respiration data, blood gas data, patient kinetic data, responsiveness data, endocrine data, metabolic data, or tissue stress marker data; and

a work level determination unit to determine said first and second patient work levels based upon at least one of said cardiac data, blood pressure data, respiration data, blood gas data, patient kinetic data, responsiveness data, endocrine data, metabolic data, or tissue stress marker data.

17. The medical device of claim 16, further comprising a work level excursion module configured to determine the work level excursion threshold based on at least one of said body data, a time of day, or a patient state.

18. The medical device of claim 17, further comprising a patient state module configured to determine the patient state based upon said body data.

19. The medical device of claim 16, further comprising:

a background activity time period module configured to provide data relating to historic patient activity in relation to time of day;

a body data activity correlation unit configured to correlate said body data to at least one of a plurality of candidate states based upon said data relating to historic patient activity; and

a patient input unit configured to receive and input from said patient.

20. The medical device of claim 16, further comprising a work level excursion module configured to determine a work level excursion threshold based at least one on said body data, time of day, or said patient state.

21. The medical device of claim 7, wherein said work level excursion is pathological.

22. The medical device of claim 7, further comprising:

a warning unit to provide a warning in response to a determine that a work level excursion has occurred;

a therapy unit configured to provide a therapy in response to a determine that a work level excursion has occurred; and

a logging unit to log at least one of an occurrence or a severity of said work level excursion, wherein logging comprises storing to memory one or more of;

at least one of a date, a time, or a severity of said detected work level excursion;

a type of therapy delivered to treat said work level excursion;

or

at least one effect of a therapy delivered to treat the work level excursion.

23. A non-transitory computer readable program storage unit encoded with instructions that, when executed by a computer, perform a method of determining a work level of a subject'"'"'s brain, comprising:

determining a first oxygen saturation, oxygen concentration, or oxygen pressure of the subject'"'"'s blood at a first location in a carotid artery;

determining a second oxygen saturation, oxygen concentration, or oxygen pressure of the subject'"'"'s blood at a second location in a jugular vein; and

determining the work level of the subject'"'"'s brain based on the first oxygen saturation, oxygen concentration, or oxygen pressure and the second oxygen saturation, oxygen concentration, or oxygen pressure.

24. The non-transitory computer readable program storage unit of claim 23, further comprising determining a difference or ratio between the first oxygen saturation, oxygen concentration, or oxygen pressure and the second oxygen saturation, oxygen concentration, or oxygen pressure.

25. The non-transitory computer readable program storage unit of claim 23, further comprising detecting a seizure based at least in part on the determined work level.

26. The non-transitory computer readable program storage unit of claim 23, further comprising classifying a seizure as a convulsive seizure or a partial seizure based at least in part on the determined work level.

27. The non-transitory computer readable program storage unit of claim 26, further comprising classifying a convulsive seizure as primarily or secondarily generalized.

28. The non-transitory computer readable program storage unit of claim 23, wherein the first location and the second location are ipsilateral, and the method further comprises determining the occurrence of a partial seizure based on the first oxygen saturation, concentration, or pressure and the second oxygen saturation, concentration, or pressure.

29. The non-transitory computer readable program storage unit of claim 23, wherein the first location and the second location are located on a first side of the patient'"'"'s body, and the method further comprises:

determining a third oxygen saturation, oxygen concentration, or oxygen pressure of the subject'"'"'s blood at a third location in a carotid artery on a second side of the patient'"'"'s body;

determining a fourth oxygen saturation, oxygen concentration, or oxygen pressure of the subject'"'"'s blood at a fourth location in a jugular vein on the second side of the patient'"'"'s body;

determining the occurrence of at least one of;

a partial seizure on the first side of the patient'"'"'s body, based on a difference between the first and second oxygen saturation oxygen concentration, or oxygen pressure being greater than a difference between the third and fourth oxygen saturation oxygen concentration, or oxygen pressure,

a partial seizure on the second side of the patient'"'"'s body, based on the difference between the first and second oxygen saturation oxygen concentration, or oxygen pressure being less than the difference between the third and fourth oxygen saturation oxygen concentration, or oxygen pressure,

a secondary generalized seizure based on a first time wise difference of the difference between the first and second oxygen saturation oxygen concentration, or oxygen pressure and the difference between the third and fourth oxygen saturation oxygen concentration, or oxygen pressure being less than a second time wise difference of the difference between the first and second oxygen saturation oxygen concentration, or oxygen pressure and the difference between the third and fourth oxygen saturation oxygen concentration, or oxygen pressure.

30. The non-transitory computer readable program storage unit of claim 23, further comprising, in response to a determination that a secondary generalized seizure occurred, determining a timing of a contralateral spread of the seizure.

31. A medical device system for determining a metabolic work level of a subject, comprising:

a first sensor configured to collect first oxygen saturation, oxygen concentration, or oxygen pressure data of a subject'"'"'s blood from a first location in a carotid artery;

a second sensor configured to collect second oxygen saturation, oxygen concentration, or oxygen pressure data of the subject'"'"'s blood from a second location in a jugular vein; and

a medical device, comprising;

a first location oxygen saturation, oxygen concentration, or oxygen pressure module configured to determine a first oxygen saturation, oxygen concentration, or pressure from said first oxygen saturation, concentration, or pressure data;

a second location oxygen saturation, oxygen concentration, or oxygen pressure module configured to determine a second oxygen saturation, oxygen concentration, or oxygen pressure from said second oxygen saturation, oxygen concentration, or oxygen pressure data;

and

a brain work level determination module configured to determine a work level of the subject'"'"'s brain based on the first oxygen saturation, oxygen concentration, or oxygen pressure and the second oxygen saturation, oxygen concentration, or oxygen pressure.

32. The medical device system of claim 31, wherein the medical device further comprises an oxygen saturation, concentration, or pressure difference module configured to determine a difference or ratio between the first oxygen saturation, concentration, or pressure and the second oxygen saturation, concentration, or pressure.