Rapid identification of epileptogenic sites in the intracranial EEG

The paper presents a novel computationally simple, easy-to-interpret compressed EEG display for multichannel intracranial EEG recordings. The compressed display is based on the level of sharp activity (relative sharpness index (RSI)) in the EEG, which profoundly increases during paroxysmal activities. RSI is graphically presented as a color-intensity plot that allows compressing several hours of EEG into a single display page. RSI display is a bird's-eye-view of the EEG that may reveal seizure evolution ('build-up'), seizure precursors, or sites associated with the seizures. We present examples from two patients to illustrate the method's ability to identify epileptogenic sites that may be difficult to observe in the conventional review process. RSI is compared with the color density spectral array (CDSA) and amplitude integrated EEG (aEEG) display. Examples demonstrate the RSI display to be simple, easy to interpret, computationally light and fast enough for online application.