Epileptic Seizure: prediction and prevention Dan Coughlin Kevin McCabe Bob McCarthy Steve Moffett

Distribution of Work Prediction Prevention Market and Product Analysis Kevin and Steve Prevention Bob Market and Product Analysis Dan

Background

Epilepsy Epilepsy is a brain disease involving abnormal neuron activity in the brain Abnormal activity triggers seizures Includes many diseases that affect the brain in this way, not just one Person is classified as epileptic after just 2 epileptic seizures

Electroencephalogram (EEG) Method of recording electrical activity of the brain. Electrical Activity produced by firing neurons in the brain. First EEG in 1912 Recorded by Vladimir Vladimirovich Pravdich-Neminsky on a dog Main clinical application: Detecting seizures and epilepsy Also has applications in entertainment

Electroencephalogram (EEG)

Prediction

Ictal vs. Inter-Ictal Ictal - the actual event; originates from the Latin ictus, meaning a blow or a stroke Inter-Ictal- the time between epileptic events Which is best?

Current Prediction Methods Using raw EEG data, the following algorithms are generally utilized: Fuzzy Logic Artificial Neural Networks (ANNs) Functional Neural Networks (FNNs) Probability Neural Networks (PNNs) Support Vector Machines (SVM)

Prevention

PREVENTION Common methods to prevent epilepsy seizures Preventing a seizure with the use of Biosensors

PREVENTION Use of medications There are a few common methods believed to help prevent epilepsy seizures Use of medications Medications does not affect all epilepsy patients They do not stop all attacks from occurring Epilepsy seizures cannot be 100% prevented by medication Identify an oncoming seizure attack by watching for behaviors, environments, or physical and emotional signs that lead to attacks If an individual is known to have a smelling sensation that occurs right before a seizure, it may be prevented by sniffing a strong odor such as garlic or roses Rubbing muscles that are twitching during an attack may also halt the seizure

PREVENTION VNS – Vagus Nerve Stimulation (passes thru neck to brain) Designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve Pulses supplied by a device similar to a pacemaker Works for 30 seconds of stimulation followed by 5 minutes of no stimulation Holding magnetic near devices activates it outside of its programmed interval Stimulation Parameters Stimulation amplitude, frequency, pulse width Relieves side effects (pain) and controls seizure

PREVENTION Molecular Imaging Biosensor Identifies excess amounts of neurotransmitter glutamate build up in brain tissue Excess levels thought to be produced by dysfunctional “glutamate-glutamine shuttle” Biological sensors being developed to detect glutamate levels from shuttle process Using FRET (fluorescence resonance energy transfer) imaging and electrical signals to detect evidence of alterations If technology is feasible and shows that epileptic seizures occur from this imbalance, this will be a potential new therapeutic way to control epilepsy

Market and Products

Types of Products Vagus Nerve Stimulation (VNS) Seizure Detection while sleeping Electrodermal Activity Sensor Audio sensors

Vagus Nerve Stimulation (VNS) “Pacemaker for the Brain” Mixed reviews from patients receiving the product More risk with an in body procedure Has removed seizures for some, but stopped hearts in others!!

Available Prevention/Detection Products Detects shaking movements typical of seizures while sleeping Placed on bed underneath sleeper, triggers alarm http://www.tunstall.co.uk/assets/Literature/477-Epilepsy_product_datasheet.pdf

Available Prevention/Detection Products Bed Sensor with Microphone to detect audible sounds sometimes associated with seizures http://www.medpage-ltd.com/MEDPAGE%20MANUAL%20MP2%20REV-01-01.04-09.pdf

Available Prevention/Detection Products Electrodermal Activity Sensor measures skin conductance Electrodes sense change when seizure occurs http://affect.media.mit.edu/pdfs/10.Poh-etal-EMBC2010.pdf

Project Timeline