Convulsive therapy apparatus to stimulate and monitor the extent of therapeutic value of the treatment

• US 5,871,517 A
• Filed: 01/15/1997
• Issued: 02/16/1999
• Est. Priority Date: 01/15/1997
• Status: Expired due to Term

• Current Assignee: Somatics Incorporated
• Original Assignee: Somatics Incorporated
• Inventors: Swartz, Conrad Melton, Abrams, Richard Stephen
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US08/784,128
• Time in Patent Office: 762 Days
• Field of Search: 607/45, 607/62
• US Class Current: 607/45
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/4833 Assessment of subject's compliance to treatment
• CPC Class Codes: A61N 1/38 for producing shock effects

Abstract

In medical convulsive therapy (CV), comprising electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), a computer system is used to analyze the effectiveness of the treatment. In one embodiment the effectiveness is determined by measuring the physiological effects on the heart (ECG) muscles (EMG) and brain (EEG).

Claims

1. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT) to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using an electroencephalographic (EEG) device and electrodes removably attached to the patient'"'"'s head;

(c) repeatedly converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over a selected time interval of 0.1 to 3 seconds and numerically integrating the samples to constitute a sequence of post-stimulus EEG area rates;

(d) displaying the sequence of said EEG area rates; and

(e) displaying the sequence of EEG area rates in summary form at the end of the CT treatment.

2. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using an electroencephalographic (EEG) device and electrodes removably attached to the patient'"'"'s head;

(c) repeatedly converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over a selected time interval of 0.1 to 3 second and numerically integrating the samples to constitute a sequence of post-stimulus EEG area rates;

(d) displaying the sequence of said EEG area rates;

(e) measuring the brain wave activity of the patient prior to the therapy by amplification of the patient'"'"'s electrical signals from the brain using the EEG device and electrodes removably attached to the patient'"'"'s head;

(f) repeatedly converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over a selected time interval of 0.1 to 3 seconds and numerically integrating the samples to constitute a sequence of pre-therapy EEG area rates;

(g) in the computer system, comparing the pre-stimulus EEG area rates and the post-stimulus EEG area rates; and

(h) displaying the results of the comparisons.

3. A method as in claim 2 wherein the selected time interval is about 1 second.

4. A method as in claim 2 including the steps of obtaining and displaying a sequence of post-stimulus EEG area rates covering the time that any post-stimulus EEG area rate exceeds a pre-stimulus EEG area rate, thereby obtaining a measurement of the endpoint and duration of the seizure and the peak and total EEG area rates during the seizure.

5. A method as in claim 2 and measuring and displaying time measured from the termination of the stimulus to onset of high-amplitude low-frequency brain waves of the patient.

6. A method as in claim 5 wherein displaying time measured comprises displaying the time to reach within a selected percentage of peak EEG voltage or peak EEG area rate.

7. A method as in claim 2 and measuring and displaying a ratio of the minimum post-stimulus EEG area rate to the pre-stimulus EEG area rate, thereby expressing a measurement of postictal suppression.

8. A method as in claim 2 and measuring and displaying a ratio of a peak post-stimulus EEG area rate to a pre-stimulus EEG area rate.

9. A method as in claim 2 and measuring a minima postictal EEG area rate and in the computer system comparing the baseline pre-stimulus EEG area rate to the postictal minima EEG area rate to provide an indication of the suppression of the baseline pre-stimulus EEG area rate due to the seizure;

and displaying the results of the comparison.

10. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using an electroencephalographic (EEG) device and electrodes removably attached to the patient'"'"'s head;

(c) repeatedly converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over a selected time interval of 0.1 to 3 seconds and numerically integrating the samples to constitute a sequence of post-stimulus EEG area rates;

(d) displaying the sequence of said EEG area rates; and

(e) measuring and displaying a ratio of a minimum post-stimulus EEG area rate to a peak post-stimulus EEG area rate.

11. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) detecting the brain wave activity of the patient by amplification of the electrical signals form the brain using an electroencephalographic (EEG) device and electrodes removably attached to the patient'"'"'s head;

(c) repeatedly converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over a selected time interval of 0.1 to 3 seconds and numerically integrating the samples to constitute a sequence of post-stimulus EEG area rates;

(d) displaying the sequence of said EEG area rates; and

(e) measuring a plurality of post-stimulus EEG area rates and calculating, in the computer system, the maxima and minima of said plurality and their times of occurrence.

12. A method as in claim 11 and displaying the times of occurrence of the maxima and minima post-stimulus EEG area rates.

13. A method as in claim 11 and calculating, in the computer system, a Suppression of Seizure Activity index based upon a comparison of the minima EEG post-stimulus EEG area rate to the maxima post-stimulus EEG area rate.

14. A method of convulsive therapy comprising electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient that describe the therapeutic value of the therapy, including the steps of:

(a) amplifying electrical signals from the patient'"'"'s brain using an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient, converting the EEG signals into a first set of EEG data, setting a baseline EEG reference based on the first set of EEG data, and storing the baseline EEG reference in a computer system having memory;

(b) employing a CT device having the computer system and removably securing an output means of the CT device on, or proximate, the head of the patient and applying power thereto to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(c) detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using the EEG device and removable electrodes, converting the amplified EEG signals into a second set of EEG data, and measuring the time that the second set of EEG data exceeds the baseline EEG reference;

(d) displaying said time; and

(e) converting the brainwaves into the first set and the second set of EEG data by digitizing samples of brain wave amplitudes over selected time intervals of 0.1 to 3 seconds and numerically integrating the samples to generate a pre-therapy EEG area rate as the baseline EEG reference and a sequence of post-stimulus EEG area rates as the second set of EEG data.

15. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient that describe the therapeutic value of the therapy, including the steps of:

(a) detecting brain wave activity of the patient prior to the CT by amplifying electrical signals from the patient'"'"'s brain using an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient, converting the EEG signals into baseline EEG data, and storing the baseline EEG data in a computer system having memory;

(b) employing a CT device having the computer system therein and removably securing an output means of electrodes of the CT device on, or proximate to, the head of the patient and applying power thereto in a convulsive therapy session with the expectation of inducing seizure;

(c) in the range of less than 30 seconds immediately following termination of the application of power to induce the seizure by the CT device, commencing detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using the EEG device and removable electrode and converting the amplified EEG signals into a second set of EEG data that describe the minimum postictal EEG amplitude; and

(d) calculating, in the computer system, and displaying the ratio of the minimum postictal EEG amplitude to the baseline EEG data.

16. A method as in claim 15 and converting the brain waves into the baseline EEG data and minimum postictal EEG by digitalizing samples of brain wave amplitudes over selected time intervals of 0.1 to 3 seconds and numerically integrating the samples to generate a pre-stimulus EEG area rate as the baseline data and a minimum postictal EEG area rate as the minimum postictal EEG.

17. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) in the range of less than 30 seconds immediately following termination of the stimulus, commencing detecting brain wave activity of the patient by amplification of electrical signals from two opposite sides of the brain using an electroencephalographic (EEG) device and electrodes removably attached opposite each other in pairs on opposite sides of the patient'"'"'s head;

(c) converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude over selected time intervals;

(d) in the computer system, analyzing the voltage differences between the digitalized samples from the electrodes within each pair and generating a seizure coherence measurement based upon the analysis; and

(e) displaying the seizure coherence measurement.

18. A method as in claim 17 wherein in (d) the analysis includes subtracting the voltage differences of each pair from a mean voltage of a plurality of pairs.

19. A method as in claim 17 wherein in (d) the analysis includes calculating at a sequence taken over time and in (e) the absolute values are displayed.

20. A method as in claim 17 wherein in (d) the analysis includes obtaining a sum of the voltage differences which is subtracted from a mean voltage.

21. A method as in claim 17 wherein in (d) analyzing the voltage differences comprises subtracting voltages over a selected time period from 0.5 to 3 seconds in length.

22. A method as in claim 21 wherein in (d) a regression coefficient or correlation coefficient is calculated based on the time period and in (e) at least one of the coefficients is displayed.

23. A method as in claim 17 wherein the seizure coherence measurement is derived from one, or more, of the following:

(i) momentary peak coherence during the seizure;

(ii) a selected time period of maximum peak coherence during the seizure;

(iii) momentary minimum coherence after the seizure;

(iv) a selected time period of minimum coherence after the seizures;

(v) coherence measurements pre-treatment as a baseline; and

(vi) coherence measurements in one or more of the selected bands of frequencies from 2.5 to 30 Hz.

24. A method of convulsive therapy (CT), comprising electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCV), to measure physiological aspects of the CT seizure of a patient that describe the therapeutic value of the therapy, including the steps, in order, of:

(a) detecting heartbeat rate of the patient by amplifying the electrical signals form the patient'"'"'s heart using an electrocardiograph (ECG) device having electrodes removably attached to the skin of the patient, converting the ECG heartbeat signals into a first set of digital ECG heart rate data representing a pre-treatment heart rate;

storing in a computer system having memory the first set of ECG data; and

(b) employing a CT device having the computer system therein and removably positioning an output means of the CT device on, or proximate to,the head of the patient and applying power to the output means to provide stimulus in a convulsive therapy session with the expectation of inducing seizure;

(c) monitoring the post-stimulus heart rate of patient by amplification of the electrical signals from the heart using the ECG device and removable electrodes and converting the amplified ECG signals into a second set of heart rate data in order to compare, in the computer system, the first and second sets of heart rate data and to determine the duration of heart rate elevation starting at the end of the stimulus and including a peak heart rate and terminating at the post-peak time at which the heart rate exceeds both;

(i) the pre-treatment heart rate; and

(ii) remains within a selected amount which is about 10% of the peak heart rate or a selected percentage of the peak heart rate; and

(d) displaying said duration of heart rate elevation.

25. A method of convulsive therapy (CT), comprising electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCV), to measure physiological aspects of the CT seizure of a patient that describe the therapeutic value of the therapy, including the steps, in order, of:

(a) detecting heartbeat rate of the patient by amplifying the electrical signals form the patient'"'"'s heart using an electrocardiograph (ECG) device having electrodes removably attached to the skin of the patient, converting the ECT heartbeat rate signals into a first set of digital ECG heart rate data representing a pre-treatment heart rate;

storing in a computer system having memory the first set of ECG data;

(b) employing a CT device having the computer system therein and removably positioning an output means of the CT device on, or proximate to, the head of the patient and applying power to the output means to provide stimulus in a convulsive therapy session with the expectation of inducing seizure;

(c) monitoring the post-stimulus heart rate of the patient by amplification of the electrical signals from the heart using the ECG device and removable electrodes and converting the amplified ECG signals into a second set of heart rate data in order to compare, in the computer system, the first and second sets of heart rate data and to determine the duration of heart rate elevation starting at the end of the stimulus and including a peak heart rate and terminating at the post-peak time at which the heart rate exceeds both;

(i) the pre-treatment heart rate; and

(ii) remains within a selected amount of the peak heart rate or a selected percentage of the peak heart rate;

in which the peak heart rate is a momentary peak heart rate; and

(d) displaying said duration of heart rate elevation.

26. A method as in claim 25 wherein the heart rate elevation is defined by determining when the post-stimulus heart rate exceeds the pre-treatment heart rate and remains within a selected amount of the peak heart beat rate by an amount that is about 10 beats per minute.

27. A method as in claim 26 in which the peak heart rate is the peak as sustained over a selected period of time or a selected number of heart beats.

28. A method as in claim 25 and measuring and displaying heart beat rate during the course of the CT treatment.

29. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) or magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient that describe the therapeutic value of the therapy, including the steps of:

(a) employing a CT device having a computer system therein, removably securing an output means of the CT device on, or proximate to, the head of the patient and applying power thereto to provide a stimulus in a convulsive therapy session with the expectation of inducing seizure;

(b) in the range of less than 30 seconds immediately following termination of the stimulus, commencing detecting the muscle activity of a muscle of the patient by amplification of the electrical signals from a muscle of the patient using an EMG device and removable electrodes and converting the amplified EMG signals into EMG data;

(c) based on the EMG data, counting the number of electrical spikes generated by the muscle; and

(d) displaying the number of EMG electrical spikes.

30. A method as in claim 29 and measuring any pauses in the spikes which exceed a selected time.

31. A method as in claim 29 and measuring and displaying the total duration of time that the electrical spikes are produced commencing at the end of the stimulus.

32. A method of measuring aspects of convulsive therapy (CT) induced seizure that describes the therapeutic value of the therapy, said method including the steps of:

(a) determining a value of at least five of the following measures immediately following the therapy;

i. peak 10-second EEG area rate;

ii. peak 10-second EEG concordance;

iii. time to onset of high-amplitude low-frequency waves;

iv. ratio of minimum postictal EEG area rate to pre-treatment EEG area rate;

v. peak heart rate;

vi. number of muscle EMG spikes; and

vii. duration of motor seizure;

(b) in a computer system, comparing the value of each of the measures to a predetermined threshold value for the same measure, the threshold values being based on group norms;

(c) in the computer system, determining if each of the measured values is below the predetermined threshold value for that measure;

(d) in the computer system, determining an Aggregate Flaw Measure (AFM) by calculation of those measures having values below their predetermined threshold values; and

(e) displaying the Aggregate Flaw Measure.

33. A method as in claim 32 wherein the predetermined value for each of the measures in (a) is based on standard values obtained from a group of patients of similar age and sex.

34. A method of measuring physiological aspects of a convulsive therapy (CV) induced seizure that describes the degree of simultaneity and spread of the seizure through the brain of a patient, said method including the steps of:

(a) measuring duration of the seizure using an electroencephalograph (EEG) device;

(b) measuring duration of the seizure using an electrocardiograph (ECG) device by measuring and calculating, using a computer system, the time from the end of the electrical stimulus to the end of persistence of the heart rate within a predetermined percentage of the heart rate peak;

(c) measuring duration of the seizure using an electromyograph (EMG) device from the end of the electrical stimulus to the last motor contraction;

(d) in the computer system, determining a mean of the durations of the seizure obtained from EEG, ECG, and EMG;

(e) in the computer system, determining differences between the mean and each of the durations of the seizure obtained by the EEG, ECT, and EMG;

(f) in the computer system, generating an Aggregate Concordance Measure (ACM) by calculations based on the determinations of (e); and

(g) displaying the Aggregate Concordance Measure.

35. A method as in claim 34 wherein the calculations of (f) are based upon:

determining an absolute value of the differences;

determining an average of the absolute values determined in (e); and

determining a product by multiplying said average by 100% and then determining a result by dividing said product by said mean.

36. A method of magnetoconvulsive therapy (MCT) to measure physiological aspects of the MCT seizure that describe the therapeutic value of the therapy, including the steps of:

(a) amplifying the electrical signals from the brain using an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient to detect EEG signals, converting the EEG signals into a first set of EEG data, setting a baseline EEG reference based on the first set of EEG data, and storing in computer system memory the baseline EEG reference;

(b) employing an MCT device, removably securing an output means of the MCT device on, or proximate, the head of the patient and applying power thereto in a convulsive therapy session with the expectation of inducing seizure;

(c) in the range of less than 30 seconds immediately following termination of the application of power to induce the seizure by the MCT device commencing detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using an EEG device and removable electrodes, converting the amplified EEG signals into a second digital set of EEG data, using a computer system to calculate the time that the second set of EEG data exceeds the baseline EEG reference; and

(d) displaying said time.

37. A method of magnetoconvulsive therapy (MCT) to measure physiological aspects of the MCT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) employing an MCT device, removably securing an output coil of the MCT device, on, or proximate, the head of the patient and applying power to the output coil in a convulsive therapy session to induce seizure;

(b) in the range of less than 30 seconds immediately following termination of the application of power to induce the seizure by the MCT device, commencing detecting the brain wave activity of the patient by amplification of the electrical signals from the brain using an electroencephalographic (EEG) device and electrodes removably attached to the patient'"'"'s head;

(c) converting the amplified EEG signals into a set of digitalized samples of the brain wave amplitude and integrating the samples to constitute a post-stimulus EEG area representing power; and

(d) displaying said post-stimulus EEG power.

38. A method of convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to describe the therapeutic value of the therapy, including the steps of:

(a) in the range of less than 30 minutes immediately preceding one CT, detecting the brain wave activity of the patient by placing EEG electrodes on the scalp of the patient and amplification and digitizing of the electrical signals from the patient'"'"'s brain using an electroencephalographic (EEG) device to obtain a baseline EEG Index, which is a measure of energy or power in one or more bandwidths;

(b) recording the baseline EEG Index;

(c) prior to a next CT treatment, repeating step (a) to obtain a subsequent EEG Index;

(d) comparing the baseline EEG index to the subsequent treatment EEG Index and adjusting the dosage or frequency of subsequent CV treatment based on the comparison.

39. A method as in claim 38 wherein the range is (a) is from 2 to 5 minutes.

40. A method as in claim 38 including performing a Fast Fourier Transform (FFT) on the brain activity in (a) and wherein the bandwidth on which the FFT is performed is in the range of 0-60 Hz.

41. A method as in claim 40 wherein the said bandwidth is in the range of 2-8 Hz.

42. A method as in claim 38 including performing a Fast Fourier Transform (FFT) on the brain wave activity in (a).

43. An apparatus in convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure of a patient and to display measurements indicating the therapeutic value of the therapy, the apparatus being a unitary instrument having an internal computer system, the apparatus including:

(a) EEG means to detect the brain wave activity of the patient prior to the CT by amplifying the electrical signals from the patient'"'"'s brain;

the EEG means including an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient to detect and amplify EEG signals, analog/digital conversion means to convert the amplified EEG signals into a first set of EEG samples, baseline means in the computer system to derive an EEG baseline area rate based on numerically integrating the samples taken over a period of 0.1 to 3 seconds and averaged, and memory means in the computer system to record EEG baseline area rate;

(b) a CT device, including an output means adapted to be secured on, or proximate to, the head of the patient and means to apply power thereto in a convulsive therapy session with the expectation of inducing seizure;

(c) means to detect and record in the memory means the postictal brain wave activity of the patient, commencing in the range of less than 30 seconds immediately following termination of the application of power to induce the seizure by the CT device, by amplification of the electrical signals from the brain using the EEG device and removable electrode;

(d) means to convert and numerically integrate the amplified postictal EEG signals into a second set of EEG samples that describe the postictal EEG area rate over a selected time interval of from 0.1 to 3 seconds;

(e) means in the computer system to compare, and generate a ratio of, the postictal EEG area rate and the baseline area rate; and

(f) means to display the ratio of the postictal EEG area rate to the baseline area rate.

44. An apparatus as in claim 43 and means to measure and display the time to onset of the patient'"'"'s postictal brain waves which are of high-amplitude within 20% of peak EEG voltage or peak area rate) and low-frequency (below 12 Hz) brain waves.

45. An apparatus as in claim 43 and means to calculate and display a ratio of a minimum postictal EEG area rate to pre-treatment EEG area rate.

46. Apparatus as in claim 43 and means to calculate and display a ratio of a minimum postictal EEG area rate to the peak post-stimulus EEG area rate.

47. Apparatus in convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure and to display measurements indicating the therapeutic value to a patient of the therapy, the apparatus being a unitary instrument having an internal computer system, the apparatus including:

(a) EEG means to detect the brain wave activity of the patient prior to the CT by amplifying the electrical signals from the patient'"'"'s brain;

the EEG means including an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient to detect and amplify EEG signals, analog/digital conversion means to convert the amplified EEG signals into a first set of EEG samples, baseline means in the computer system to derive an EEG baseline area rate based on numerically integrating the first set of EEG samples taken over a period of 0.1 to 3 seconds, and memory means in the computer to record the EEG baseline area rate;

(b) a CT device, including an output means adapted to be secured on, or proximate to, the head of the patient and means to apply power thereto in a convulsive therapy session with the expectation of inducing seizure;

(c) means to detect and record in the computer system memory the postictal brain wave activity of the patient, commencing in the range of less than 30 seconds immediately following termination of the application of power to induce the seizure by the CT device, by amplification of the electrical signals from the brain using the EEG device and removable electrode;

(d) means to convert the amplified postictal EEG signals into a second set of EEG samples that describe the postictal peak EEG area rate over a selected time interval of from 0.1 to 3 seconds;

(e) computer means to compare and generate the time that the EEG area rate exceeds the baseline area rate; and

(f) means to display the time that the peak EEG area rate exceeds the baseline area rate.

48. Apparatus as in claim 47 and means to measure and display the time to onset of the patient'"'"'s postictal high-amplitude (within 20% of peak EEG voltage or area rate) and low-frequency (2-12.5 Hz) brain waves.

49. Apparatus as in claim 47 and means to calculate and display a ratio of a minimum postictal EEG area rate to baseline EEG area rate.

50. Apparatus as in claim 47 and means to calculate and display a ratio of a minimum postictal EEG area rate to the postictal peak EEG area rate.

51. Apparatus in convulsive therapy (CT), which comprises electroconvulsive therapy (ECT) and magnetoconvulsive therapy (MCT), to measure physiological aspects of the CT seizure and to display measurements indicating the therapeutic value to a patient of the therapy, the apparatus being a unitary instrument having an internal computer system, the apparatus including:

(a) EEG means to detect the brain wave activity of the patient prior to the CT by amplifying the electrical signals from the patient'"'"'s brain;

the EEG means including an electroencephalographic (EEG) device having an electrode removably attached to the head of the patient to detect and amplify EEG signals, analog/digital conversion means to convert the amplified EEG signals into a first set of EEG samples, baseline means in the computer system to derive an EEG baseline area rate based on numerically integrating the samples taken over a period of 0.1 to 3 seconds, and memory means in the computer system to record the EEG baseline area rate;

(b) a CT device, including an output means adapted to be secured on, or proximate, the head of the patient and means to apply power thereto in a convulsive therapy session with the expectation of inducing seizure;

(c) means to detect and record, in the memory of the computer system, the postictal brain wave activity of the patient, commencing in the range of less than 30 seconds immediately following termination of the application of electricity to induce the seizure, by amplification of the electrical signals from the brain using the EEG device and removable electrode;

(d) means to convert the amplified EEG signals into a second set of EEG samples, over a selected time interval of from 0.1 to 3 seconds that describe the minimum postictal EEG area rate;

(e) computer means to compare, and generate a ratio, of the minimum postictal EEG area rate to the baseline area rate; and

(f) means to display said ratio.

52. Apparatus as in claim 51 and means to measure and display the time to onset of the patient'"'"'s post-stimulus high-amplitude low-frequency waves.

53. Apparatus as in claim 51 and means to display the ratio of the minimum postictal EEG area rate to postictal peak EEG area rate.