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Summary: This study evaluates a new automated patient-specific method for epileptic seizure detection using scalp electroencephalogram (EEG). The method relies on a normalized wavelet-based index, named the combined seizure index (CSI), and requires a seizure example and a nonseizure EEG interval as reference. The CSI is derived for every epoch in each EEG channel and is sensitive to both the rhythmicity and relative energy of that epoch and the consistency of EEG patterns among different channels. Increasing significantly as seizures occur, the CSI is monitored using a one-sided cumulative sum test to generate appropriate alarms in each channel. A seizure alarm is finally generated according to channel-based information. The proposed method was evaluated using the scalp EEG test data of approximately 236 hours from 26 patients with a total of 79 focal seizures, achieving a high sensitivity of approximately 91% with a false detection rate of 0.33 per hour and a median detection latency of 7 seconds. In addition, statistical analysis revealed that the average CSI around the onset on the side of the focus in patients with temporal lobe epilepsy (TLE) is significantly greater than that of the opposite side (P < 0.001), indicating the capability of this index in lateralizing the seizure focus in this type of epilepsy.

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