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

• US 9,186,106 B2
• Filed: 09/11/2014
• Issued: 11/17/2015
• 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:
  US14/483,979
• Publication Number:
  US 20150005592A1
• Time in Patent Office: 432 Days
• Field of Search: None
• US Class Current: 1/1
• 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 a respiratory signal indicative of the patient'"'"'s respiration;

determining at least one respiratory feature from the respiratory signal;

receiving a kinetic signal indicative of the patient'"'"'s kinetic activity;

determining at least one kinetic feature from the kinetic signal;

detecting an epileptic seizure based on the at least one respiratory feature and the at least one kinetic feature; and

performing a further action in response to said detecting, wherein said further action comprises one or more of;

logging the occurrence of the epileptic seizure;

logging the time of occurrence of the epileptic the seizure;

logging the date of occurrence of the epileptic seizure;

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

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

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

assessing the severity of the epileptic seizure;

determining the end of the epileptic seizure;

determining the beginning of a post-ictal period;

determining the end of a post-ictal period; and

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

2. The method of claim 1, wherein determining at least one respiratory feature comprises determining at least one of a respiration rate, a rate of change of a respiration rate, a respiration frequency, a respiratory rhythm, a tidal volume, a minute volume, a respiratory wave morphology, a respiratory sound, an end-tidal CO2 concentration, an intercostal EMG value, a diaphragmatic EMG value, a chest wall motion value, an abdominal wall motion value, a change in respiration rate, a rate of change in respiration rate, an apnea episode, a hypopnea episode, a hyperpnea episode, and an airflow velocity.

3. The method of claim 2, wherein detecting an epileptic seizure based on the at least one respiratory feature comprises detecting a change in at least one of the patient'"'"'s respiration rate, frequency, rhythm, tidal volume, or minute volume to a value outside an interictal reference value range.

4. The method of claim 3, wherein determining the end of a post-ictal period is based on at least one of the patient'"'"'s respiration rate, frequency, tidal volume or minute volume returning to a value within an interictal reference value range.

5. The method of claim 1, wherein determining at least one kinetic feature comprises determining at least one of a direction of movement, a speed of movement, a frequency of movement, an acceleration in one, two or three dimensions, a trajectory of movement, a pattern of movement, a quality of a movement, a force of contraction of a muscle, a body posture, a body orientation, a body position, a muscle tone an agonist- to-antagonist muscle tone relation, a gait, and a fall.

6. The method of claim 1, wherein detecting an epileptic seizure is based on the temporal relationship between the at least one respiratory feature and the at least one kinetic feature.

7. The method of claim 1, wherein detecting an epileptic seizure is based on changes in at least one of the respiratory feature and the kinetic feature.

8. The method of claim 1, wherein determining at least one respiratory feature comprises determining at least one of a respiration rate, a respiratory rhythm, a tidal volume, a minute volume, and a respiration pattern.

9. The method of claim 8, wherein detecting an epileptic seizure is based on at least one of a respiratory rate, a respiratory rhythm, a tidal volume, a minute volume, and a respiration pattern outside of an interictal reference value range.

10. The method of claim 1, wherein detecting said epileptic seizure is based on determining an apnea episode followed by a hypopnea episode.

11. The method of claim 1, wherein determining the end of the epileptic seizure comprises determining an increase in at least one of the patient'"'"'s respiratory rate, tidal volume, and minute volume.

12. The method of claim 1, wherein determining the end of the epileptic seizure comprises determining that at least one of the patient'"'"'s respiratory rate, respiratory rhythm, tidal volume, minute volume, and respiratory pattern has returned to an interictal reference value range.

13. The method of claim 1, further comprising determining the beginning of a post-ictal period based at least in part on determining, after detecting an epileptic seizure, a change in at least one of the patient'"'"'s respiratory rate, respiratory rhythm, frequency, tidal volume, and minute volume to a value outside an ictal reference value range.

14. The method of claim 1, further comprising:

administering at least one of a responsiveness test and an awareness test to the patient; and

determining a result for said at least one of a responsiveness test and an awareness test;

wherein detecting an epileptic seizure is dependent on said patient failing said at least one of a responsiveness test and an awareness test.

15. The method of claim 1, further comprising:

administering at least one of a responsiveness test and an awareness test to the patient;

determining a result for said at least one of a responsiveness test and an awareness test; and

at least one of classifying said epileptic seizure or identifying a false positive detection based at least in part on the result of said at least one of a responsiveness test and an awareness test.

16. The method of claim 1, further comprising classifying the seizure as at least one of:

an epileptic seizure;

a non-epileptic seizure;

a primarily generalized seizure;

a secondarily generalized seizure;

a complex partial seizure;

a simple partial seizure.

17. A method, comprising:

receiving a respiratory signal indicative of the patient'"'"'s respiration;

determining at least one respiratory feature from the respiratory signal;

receiving a cardiac signal indicative of the patient'"'"'s cardiac activity;

determining at least one cardiac feature from the cardiac signal;

detecting an epileptic seizure based on the at least one respiratory feature and the at least one cardiac feature; and

performing a further action in response to said detecting, wherein said further action comprises one or more of;

logging the occurrence of the epileptic seizure;

logging the time of occurrence of the epileptic the seizure;

logging the date of occurrence of the epileptic seizure;

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

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

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

assessing the severity of the epileptic seizure;

determining the end of the epileptic seizure; and

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

18. A method, comprising:

receiving a respiratory signal indicative of the patient'"'"'s respiration;

determining at least one respiratory feature from the respiratory signal;

receiving at least one of cardiac signal indicative of the patient'"'"'s cardiac activity and a kinetic signal indicative of a body movement of the patient;

determining at least one of a cardiac feature from the cardiac signal and a kinetic feature from the kinetic signal;

detecting an epileptic seizure based on the at least one respiratory feature and at least one of said cardiac feature and said kinetic feature; and

performing a further action in response to said detecting, wherein said further action comprises one or more of;

logging the occurrence of the epileptic seizure;

logging the time of occurrence of the epileptic the seizure;

logging the date of occurrence of the epileptic seizure;

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

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

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

assessing the severity of the epileptic seizure;

determining the end of the epileptic seizure; and

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

19. A system, comprising:

at least one respiratory sensor for sensing a respiratory signal indicative of the patient'"'"'s respiration;

at least one kinetic sensor to sense a body movement signal of the patient;

at least one feature determination unit for determining

at least one respiratory feature from the respiratory signal and

at least one kinetic feature from the body movement signal;

at least one seizure detection unit configured to detect the occurrence of an epileptic seizure based on the respiratory feature and the kinetic feature; and

an action unit configured to receive an indication of said occurrence of said epileptic seizure from said detection unit and perform at least one of

logging the occurrence of the epileptic seizure;

logging the time of occurrence of the epileptic the seizure;

logging the date of occurrence of the epileptic seizure;

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

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

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

assessing the severity of the epileptic seizure;

determining the end of the epileptic seizure; and

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

20. The system of claim 19, further comprising at least one of a cardiac sensor for sensing a cardiac signal indicative of the patient'"'"'s cardiac activity, an awareness determination unit for determining the patient'"'"'s awareness, and a responsiveness determination unit for determining the patient'"'"'s responsiveness.