Seizure detection algorithm adjustment

• US 10,543,359 B2
• Filed: 04/29/2009
• Issued: 01/28/2020
• Est. Priority Date: 11/11/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Giftakis, Jonathon E., Torgerson, Nathan A.
• Primary Examiner(s): Berhanu, Etsub D
• Assistant Examiner(s): Catina, Michael A
• Application Number:
  US12/432,268
• Publication Number:
  US 20100121215A1
• Time in Patent Office: 3,926 Days
• Field of Search: 600300, 600301, 600544, 600545, 607 45, 607 46, 607 48, 607 50
• CPC Class Codes: A61B 5/031 Intracranial pressure
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease

Abstract

A medical system implements a seizure detection algorithm to detect a seizure based on a first patient parameter. The medical system monitors a second patient parameter to adjust the seizure detection algorithm. In some examples, the medical system determines whether a seizure for which therapy delivery is desirable occurred based on a second patient parameter. If a target seizure occurred, and the seizure detection algorithm did not detect the target seizure, the medical system adjusts the seizure detection algorithm to detect the target seizure. For example, the medical system may determine a first patient parameter characteristic indicative of the target seizure detected based on the second patient parameter and store the first patient parameter characteristic as part of the seizure detection algorithm. In some examples, the first patient parameter is an electrical brain signal and the second patient parameter is patient activity (e.g., patient motion or posture).

Claims

1. A method comprising:

receiving, with processing circuitry, a first signal indicative of a physiological parameter of a patient, wherein the physiological parameter comprises a bioelectrical brain signal;

receiving, with the processing circuitry, a second signal indicative of a patient parameter of the patient, wherein the patient parameter comprises at least one of patient motion, patient posture, intracranial pressure, respiration rate, heart rate, or muscle activity; and

adjusting, with the processing circuitry, a seizure detection algorithm of a medical device based on the first and second signals, wherein adjusting the seizure detection algorithm comprises;

identifying, with the processing circuitry, a target seizure based on the second signal;

determining, with the processing circuitry, that the medical device, while implementing the seizure detection algorithm, did not identify the target seizure based on the first signal;

in response to determining that the medical device did not identify the target seizure based on the first signal, determining that a portion of the first signal associated with the target seizure is not indicative of a baseline non-seizure state of the patient; and

in response to determining that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient, adjusting, with the processing circuitry, the seizure detection algorithm.

2. The method of claim 1, wherein determining that the medical device did not identify the target seizure comprises determining whether the medical device delivered therapy to the patient or generated a patient notification prior to or upon occurrence of the target seizure.

3. The method of claim 1, wherein adjusting the seizure detection algorithm comprises:

determining a characteristic of the first signal that is indicative of the target seizure; and

storing the characteristic as part of the seizure detection algorithm.

4. The method of claim 3, wherein determining the characteristic of the first signal indicative of the target seizure comprises:

identifying a first portion of the first signal temporally correlating to a second portion of the second signal that is indicative of the target seizure; and

determining the characteristic based on the first portion of the first signal.

5. The method of claim 3, wherein the characteristic of the first signal comprises at least one of a signal amplitude, signal frequency, signal pattern, slope or frequency band characteristic of the first signal.

6. The method of claim 1, wherein the target seizure comprises a first target seizure, the method further comprising:

with the processing circuitry, temporally correlating the first and second signals;

determining, with the processing circuitry, that the medical device, while implementing the seizure detection algorithm, identified a second target seizure based on the first signal;

determining, with the processing circuitry, that the second signal temporally correlated with the first signal is not indicative of the second target seizure; and

in response to determining that the second signal is not indicative of the second target seizure, adjusting, with the processing circuitry, the seizure detection algorithm.

7. The method of claim 6, wherein adjusting the seizure detection algorithm in response to determining that the second signal is not indicative of the second target seizure comprises:

determining a characteristic of the first signal that is indicative of the second target seizure; and

removing the characteristic from the seizure detection algorithm.

8. The method of claim 1, wherein the patient parameter comprises intracranial pressure.

9. The method of claim 1, wherein the second signal is indicative of motor activity of the patient.

10. The method of claim 1, wherein the patient parameter comprises at least one of respiration rate, heart rate, or muscle activity of the patient.

11. The method of claim 1, wherein identifying the target seizure based on the second signal comprises determining, with the processing circuitry, whether an amplitude of the second signal is greater than or equal to a threshold value, wherein the amplitude being greater than or equal to the threshold value indicates occurrence of the target seizure.

12. The method of claim 1, wherein determining that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient comprises comparing a first signal characteristic of the portion of the first signal to a second signal characteristic of the first signal associated with the baseline non-seizure state.

13. The method of claim 1, further comprising:

identifying, using the adjusted seizure detection algorithm, the target seizure of the patient; and

responsive to identifying the target seizure using the adjusted seizure detection algorithm, controlling delivery of electrical stimulation therapy to a brain of the patient.

14. The method of claim 1, further comprising:

identifying, using the adjusted seizure detection algorithm, the target seizure of the patient; and

responsive to identifying the target seizure using the adjusted seizure detection algorithm, presenting, to the patient, an alert indicating that the target seizure was identified.

15. A system comprising:

a first sensor configured to generate a first signal indicative of a physiological parameter of a patient, wherein the physiological parameter comprises a bioelectrical brain signal;

a second sensor configured to generate a second signal indicative of a patient parameter of the patient, wherein the patient parameter comprises at least one of patient motion, patient posture, intracranial pressure, respiration rate, heart rate, or muscle activity; and

processing circuitry configured to receive the first and second signals and adjust a seizure detection algorithm of a medical device based on the first and second signals, wherein the processing circuitry is configured to adjust the seizure detection algorithm by at least;

identifying a target seizure based on the second signal,

determining that the medical device, while implementing the seizure detection algorithm, did not identify the target seizure based on the first signal,

in response to determining that the medical device did not identify the target seizure based on the first signal, determining that a portion of the first signal associated with the target seizure is not indicative of a baseline non-seizure state of the patient, and

in response to determining that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient, adjusting the seizure detection algorithm.

16. The system of claim 15, wherein the processing circuitry is configured to adjust the seizure detection algorithm by at least determining a characteristic of the first signal that is indicative of the target seizure based on the first and second signals and storing the characteristic as part of the seizure detection algorithm.

17. The system of claim 16, wherein the characteristic of the first signal comprises at least one of a signal amplitude, signal frequency, signal pattern, slope or frequency band characteristic of the first signal.

18. The system of claim 15, wherein the target seizure comprises a first target seizure, and wherein the processing circuitry is configured to temporally correlate the first and second signals, determine that the medical device, while implementing the seizure detection algorithm, identified a second target seizure based on the first signal, determine that the second signal temporally correlated with the first signal is not indicative of the second target seizure, and, in response to determining that the second signal is not indicative of the second target seizure, adjust the seizure detection algorithm.

19. The system of claim 18, wherein the processing circuitry is configured to adjust the seizure detection algorithm by at least determining a characteristic of the first signal that is indicative of the second target seizure, and removing the characteristic from the seizure detection algorithm.

20. The system of claim 15, wherein the patient parameter comprises intracranial pressure.

21. The system of claim 15, wherein the second signal is indicative of motor activity of the patient.

22. The system of claim 15, wherein the patient parameter comprises at least one of respiration rate, heart rate, or muscle activity of the patient.

23. The system of claim 15, the processor is configured to determine whether an amplitude of the second signal is greater than or equal to a threshold value, and identify the target seizure if the amplitude is greater than or equal to the threshold value.

24. The system of claim 15, wherein the processing circuitry is configured to determine that the medical device did not identify the target seizure by at least determining whether the medical device delivered therapy to the patient or generated a patient notification prior to or upon occurrence of the target seizure.

25. The system of claim 15, further comprising a memory configured to store a first signal characteristic indicative of the baseline non-seizure state, wherein the processing circuitry is configured to determine that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient by at least comparing a second signal characteristic of the portion of the first signal to the first signal characteristic associated with the baseline non-seizure state.

26. The system of claim 15, further comprising a stimulation generator configured to deliver electrical stimulation therapy, wherein the processing circuitry is configured to:

identify, using the adjusted seizure detection algorithm, the target seizure of the patient; and

responsive to identifying the target seizure using the adjusted seizure detection algorithm, control the stimulation generator to deliver electrical stimulation therapy to a brain of the patient.

27. The system of claim 15, further comprising an external programmer, wherein the processing circuitry is configured to:

identify, using the adjusted seizure detection algorithm, the target seizure of the patient; and

responsive to identifying the target seizure using the adjusted seizure detection algorithm, present, to the patient and via the external programmer, an alert indicating that the target seizure was identified.

28. A system comprising:

means for generating a first signal indicative of a physiological parameter of a patient, wherein the physiological parameter comprises a bioelectrical brain signal;

means for generating a second signal indicative of a patient parameter of the patient, wherein the patient parameter comprises at least one of intracranial pressure, patient motion, patient posture, respiration rate, heart rate, or muscle activity of the patient; and

means for adjusting a seizure detection algorithm of a medical device based on the first and second signals, wherein the means for adjusting the seizure detection algorithm adjusts the seizure detection algorithm by at least;

identifying a target seizure based on the second signal;

determining that the medical device, while implementing the seizure detection algorithm, did not identify the target seizure based on the first signal;

in response to determining the medical device did not identify the target seizure based on the first signal, determining that a portion of the first signal associated with the target seizure is not indicative of a baseline non-seizure state of the patient; and

in response to determining that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient, adjusting the seizure detection algorithm.

29. The system of claim 28, wherein the second signal is indicative of motor activity of the patient.

30. The system of claim 28, wherein the target seizure comprises a first target seizure, the system further comprising:

means for temporally correlating the first and second signals;

means for determining that the medical device, while implementing the seizure detection algorithm, identified a second target seizure based on the first signal; and

means for determining that the second signal temporally correlated with the first signal is not indicative of the second target seizure, wherein, in response to determining that the second signal is not indicative of the second target seizure, the means for adjusting the seizure detection algorithm adjusts the seizure detection algorithm.

31. The system of claim 30, wherein the means for adjusting the seizure detection algorithm adjusts the seizure detection algorithm by at least:

determining a characteristic of the first signal that is indicative of the second target seizure; and

removing the characteristic from the seizure detection algorithm.

32. The system of claim 28, wherein the means for adjusting the seizure detection algorithm identifies the target seizure based on the second signal by at least determining whether an amplitude of the second signal is greater than or equal to a threshold value, wherein the amplitude being greater than or equal to the threshold value indicates occurrence of the target seizure.

33. The system of claim 28, wherein the means for adjusting the seizure detection algorithm determines that the medical device did not identify the target seizure by at least determining whether the medical device delivered therapy to the patient or generated a patient notification prior to or upon occurrence of the target seizure.

34. The system of claim 28, wherein the means for adjusting the seizure detection algorithm adjusts the seizure detection algorithm by at least determining a characteristic of the first signal that is indicative of the target seizure, and storing the characteristic as part of the seizure detection algorithm.

35. The system of claim 28, wherein the means for adjusting the seizure detection algorithm determines that the portion of the first signal associated with the target seizure is not indicative of the baseline non-seizure state of the patient by at least comparing a first signal characteristic of the portion of the first signal to a second signal characteristic of the first signal associated with the baseline non-seizure state.