Convulsive therapy apparatus to stimulate and monitor the extent of therapeutic value of the treatment
First Claim
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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.
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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).
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Citations
53 Claims
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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:
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(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.
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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:
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(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. - View Dependent Claims (3, 4, 5, 6, 7, 8, 9)
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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:
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(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.
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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:
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(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. - View Dependent Claims (12, 13)
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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:
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(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.
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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:
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(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. - View Dependent Claims (16)
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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:
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(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. - View Dependent Claims (18, 19, 20, 21, 22, 23)
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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:
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(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.
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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:
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(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. - View Dependent Claims (26, 27, 28)
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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:
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(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. - View Dependent Claims (30, 31)
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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:
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(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. - View Dependent Claims (33)
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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:
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(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. - View Dependent Claims (35)
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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:
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(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.
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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:
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(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.
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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:
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(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. - View Dependent Claims (39, 40, 41, 42)
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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:
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(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. - View Dependent Claims (44, 45, 46)
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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:
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(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. - View Dependent Claims (48, 49, 50)
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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:
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(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. - View Dependent Claims (52, 53)
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Specification