Using Interictal HFOs to Improve the Identification of Epileptogenic Zones in Preparation for Epilepsy Surgery

For the more than 15 million patients who have drug-resistant epilepsy, surgical resection of the region where seizure arise is often the only alternative therapy. However, the identification of this epileptogenic zone (EZ) is often imprecise. Generally, insufficient EZ identification and resection may cause seizures to continue and too much resection may lead to unnecessary neurological deficits. In this paper, an automatic high frequency oscillations (HFOs) detection method based on noise-assisted multivariate EMD (NA-MEMD) is proposed to improve the localization of the EZ for epilepsy patients. In this method, different detected HFO types such as fast-ripple (FR), ripple (R), and fast-ripple concurrent with ripple (FRandR) are utilized to investigate their clinical relevance in identifying EZ. The proposed method may significantly improve the precision by which pathological brain tissue can be identified.