An automated seizure monitoring system for patients with indwelling recording electrodes.

An automated monitoring system has been developed to record from indwelling electrode arrays in patients undergoing evaluation for surgical treatment of intractable seizures. The functional aspects of this system's design are discussed and the range of electrical seizure patterns, other epileptiform events and artifacts that the system must handle are described. The system includes a flowing graphics image of as many as 32 channels of real-time ECoG, automatic seizure detection, recording of the ECoG for up to 6 min prior to seizure onset, and EEG for 792 clinical and subclinical seizures during 1578 h of monitoring with an artifact rate of 28% for all events recorded. However, system performance was judged upon the 86% accuracy for detection and recording of patient-specific seizure patterns (multiple seizures with the same pattern counted as 1) with 1.26 brief spike bursts and 0.67 artifacts/h.