A multistage, multimethod approach for automatic detection and classification of epileptiform EEG

An efficient system for detection of epileptic activity in ambulatory electroencephalogram (EEG) must be sensitive to abnormalities while keeping the false-detection rate to a low level. Such requirements could be fulfilled neither by a single stage nor by a simple method strategy, due to the extreme variety of EEG morphologies and frequency of artifacts. The present study proposes a robust system that combines multiple signal-processing methods in a multistage scheme, integrating adaptive filtering, wavelet transform, an artificial neural network, and expert system. The system consists of two main stages: a preliminary screening stage in which data are reduced significantly, followed by an analytical stage. Unlike most systems that merely focus on sharp transients, our system also takes into account slow waves. A nonlinear filter for separation of nonstationary and stationary EEG components is also developed. The system was evaluated on testing data from 81 patients, totaling more than 800 hours of recordings. 90.0% of the epileptic events were correctly detected. The detection rate of sharp transients was 98.0% and overall false-detection rate was 6.1%. We conclude that our system has good performance in detecting epileptiform activities and the multistage multimethod approach is an appropriate way of solving this problem.