Individualized Seizure Cluster Prediction Using Machine Learning and Chronic Ambulatory Intracranial EEG

Krishnakant V. Saboo, Yurui Cao, Vaclav Kremen, Vladimir Sladky, Nicholas M. Gregg, Paul M. Arnold, Philippa J. Karoly, Dean R. Freestone, Mark J. Cook, Gregory A. Worrell, Ravishankar K. Iyer

Research output: Contribution to journalArticlepeer-review


Epilepsy patients often experience acute repetitive seizures, known as seizure clusters, which can progress to prolonged seizures or status epilepticus if left untreated. Predicting the onset of seizure clusters is crucial to enable patients to receive preventative treatments. Additionally, studying the patterns of seizure clusters can help predict the seizure type (isolated or cluster) after observing a just occurred seizure. This paper presents machine learning models that use bivariate intracranial EEG (iEEG) features to predict seizure clustering. Specifically, we utilized relative entropy (REN) as a bivariate feature to capture potential differences in brain region interactions underlying isolated and cluster seizures. We analyzed a large ambulatory iEEG dataset collected from 15 patients and spanned up to 2 years of recordings for each patient, consisting of 3341 cluster seizures (from 427 clusters) and 369 isolated seizures. The dataset's substantial number of seizures per patient enabled individualized analyses and predictions. We observed that REN was significantly different between isolated and cluster seizures in majority of the patients. Machine learning models based on REN: 1) predicted whether a seizure will occur soon after a given seizure with up to 69.5% Area under the ROC Curve (AUC), 2) predicted if a seizure is the first one in a cluster with up to 55.3% AUC, outperforming baseline techniques. Overall, our findings could be beneficial in addressing the clinical burden associated with seizure clusters, enabling patients to receive timely treatments and improving their quality of life.

Original languageEnglish (US)
Pages (from-to)818-827
Number of pages10
JournalIEEE Transactions on Nanobioscience
Issue number4
StatePublished - Oct 1 2023
Externally publishedYes


  • Seizure clusters
  • bivariate feature
  • intracranial EEG (iEEG)
  • relative entropy (REN)
  • seizure cluster prediction

ASJC Scopus subject areas

  • Bioengineering
  • Electrical and Electronic Engineering
  • Biotechnology
  • Biomedical Engineering
  • Medicine (miscellaneous)
  • Computer Science Applications
  • Pharmaceutical Science


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