Seizure Prediction Research Articles

Concept-drifts adaptation for machine learning EEG epilepsy seizure prediction.

Seizure prediction remains a challenge, with approximately 30% of patients unresponsive to conventional treatments. Addressing this issue is crucial for improving patients' quality of life, as timely intervention can mitigate the impact of seizures. In this research field, it is critical to identify the preictal interval, the transition from regular brain activity to a seizure. While previous studies have explored various Electroencephalogram (EEG) based methodologies for prediction, few have been clinically applicable. Recent studies have underlined the dynamic nature of EEG data, characterised by data changes with time, known as concept drifts, highlighting the need for automated methods to detect and adapt to these changes. In this study, we investigate the effectiveness of automatic concept drift adaptation methods in seizure prediction. Three patient-specific seizure prediction approaches with a 10-minute prediction horizon are compared: a seizure prediction algorithm incorporating a window adjustment method by optimising performance with Support Vector Machines (Backwards-Landmark Window), a seizure prediction algorithm incorporating a data-batch (seizures) selection method using a logistic regression (Seizure-batch Regression), and a seizure prediction algorithm with a dynamic integration of classifiers (Dynamic Weighted Ensemble). These methods incorporate a retraining process after each seizure and use a combination of univariate linear features and SVM classifiers. The Firing Power was used as a post-processing technique to generate alarms before seizures. These methodologies were compared with a control approach based on the typical machine learning pipeline, considering a group of 37 patients with Temporal Lobe Epilepsy from the EPILEPSIAE database. The best-performing approach (Backwards-Landmark Window) achieved results of 0.75 ± 0.33 for sensitivity and 1.03 ± 1.00 for false positive rate per hour. This new strategy performed above chance for 89% of patients with the surrogate predictor, whereas the control approach only validated 46%.

Unsupervised Multivariate Feature-Based Adaptive Clustering Analysis of Epileptic EEG Signals.

Supervised classification algorithms for processing epileptic EEG signals rely heavily on the label information of the data, and existing supervised methods cannot effectively solve the problem of analyzing unlabeled epileptic EEG signals. In the traditional unsupervised clustering algorithm, the number of clusters and the global parameters must be predetermined, and the algorithm's analytical results are combined with a huge number of subjective errors, which affects the detection accuracy. For this reason, this paper proposes an unsupervised multivariate feature adaptive clustering analysis algorithm based on epileptic EEG signals. First, CEEMDAN and CWT are introduced into the epileptic EEG signal after preprocessing for joint denoising to further improve the signal quality. Then, the multivariate feature set of the signal is extracted and constructed, which includes nonlinear, time, frequency, and time-frequency characteristics. To reveal the hidden structures and correlations in the high-dimensional feature data, t-SNE dimensionality reduction is introduced. Finally, the DBSCAN clustering algorithm is optimized using the SSA algorithm to achieve adaptive selection of cluster number and global parameters.It not only enhances the clustering performance and reliability of the clustering results, but also avoids subjective errors in the analysis results. It provides a pre-theoretical foundation for the successful development of future seizure prediction devices and has good application prospects in clinical diagnosis and daily monitoring of patients.

Forecasting Epileptic Seizures Using XGBoost Methodology and EEG Signals

INTRODUCTION: Epilepsy denotes a disorder of neurological origin marked by repetitive and spontaneous seizures without any apparent trigger. Seizures occur due to abrupt and heightened electricity flowing through the brain, which can lead to physical and mental symptoms. There are several types of epileptic seizures, and epilepsy itself can be caused by various underlying conditions. EEG (Electroencephalogram) is one of the most important and widely used tools for epileptic seizure prediction and diagnosis. EEG uses skull sensors to record electrical signals from the brain., and it can provide valuable insights into brain activity patterns associated with seizures.
 OBJECTIVES: Brain-computer interface technology pathway for analyzing the EEG signals for seizure prediction to eliminate the class imbalance issue from our dataset in this case, a SMOTE approach is applied. It is observable that there are more classes of one variable than there are of the others in the output variable. This will be problematic when employing different Artificial intelligence techniques since these algorithms are more likely to be biased towards a certain variable because of its high prevalence
 METHODS: SMOTE approaches will be used to address this bias and balance the number of variables in the response variable. To develop an XGBoost (Extreme Gradient Boosting) model using SMOTE techniques to increase classification accuracy.
 RESULTS: The results show that the XGBoost method achieves a 98.7% accuracy rate.
 CONCLUSION: EEG-based model for seizure type using the XGBoost model for predicting the disease early. The Suggested method could significantly reduce the amount of time needed to accomplish seizure prediction.

Prediction of central nervous system oxygen toxicity symptoms using electrodermal activity and machine learning

ObjectiveBreathing elevated oxygen partial pressures (PO2) prior to SCUBA diving increases the risk of developing central nervous system oxygen toxicity (CNS-OT), which could impair performance or result in seizure and subsequent drowning. We aimed to study the dynamics of electrodermal activity (EDA) while breathing elevated PO2 in the hyperbaric environment (HBO2) as a possible means to predict impending CNS-OT. To this end, we used machine learning to automatically detect and predict the onset of symptoms associated with CNS-OT in humans by using features derived from EDA in both time and frequency domains. MethodsWe collected electrodermal activity (EDA) data from forty-nine exposures to HBO2 while subjects were undergoing cognitive load and exercise in a hyperbaric oxygen chamber. Four independent experts were present during the experiment to monitor and classify any symptoms associated with hyperbaric oxygen toxicity. We computed a highly sensitive time varying spectral EDA index, named TVSymp, and extracted informative features from skin conductance responses (SCRs). Machine learning algorithms were trained and validated for classifying features from SCRs and TVSymp as CNS-OT related or non-CNS-OT related. Machine learning models were validated using a subject-independent leave one subject out (LOSO) validation scheme. ResultsOur machine learning model was able to classify EDA dynamics related to CNS-OT with 100 % sensitivity and 84 % specificity via LOSO validation. Moreover, the median prediction time for CNS-OT symptoms was ∼ 250 s preceding the occurrence of actual symptoms. SignificanceThis study shows that EDA can potentially be used for early prediction of CNS-OT in divers with a high sensitivity and sufficient prediction time for countermeasures. While the study results are promising, independent validation datasets are warranted to confirm the findings. However, the current results are well corroborated in an animal study, which consistently showed seizure prediction time of 2 min prior to seizure.

A Mutual Information-Based Many-Objective Optimization Method for EEG Channel Selection in the Epileptic Seizure Prediction Task

A Mutual Information-Based Many-Objective Optimization Method for EEG Channel Selection in the Epileptic Seizure Prediction Task

Epileptic seizure prediction based on EEG using pseudo-three-dimensional CNN.

Epileptic seizures are characterized by their sudden and unpredictable nature, posing significant risks to a patient's daily life. Accurate and reliable seizure prediction systems can provide alerts before a seizure occurs, as well as give the patient and caregivers provider enough time to take appropriate measure. This study presents an effective seizure prediction method based on deep learning that combine with handcrafted features. The handcrafted features were selected by Max-Relevance and Min-Redundancy (mRMR) to obtain the optimal set of features. To extract the epileptic features from the fused multidimensional structure, we designed a P3D-BiConvLstm3D model, which is a combination of pseudo-3D convolutional neural network (P3DCNN) and bidirectional convolutional long short-term memory 3D (BiConvLstm3D). We also converted EEG signals into a multidimensional structure that fused spatial, manual features, and temporal information. The multidimensional structure is then fed into a P3DCNN to extract spatial and manual features and feature-to-feature dependencies, followed by a BiConvLstm3D input to explore temporal dependencies while preserving the spatial features, and finally, a channel attention mechanism is implemented to emphasize the more representative information in the multichannel output. The proposed has an average accuracy of 98.13%, an average sensitivity of 98.03%, an average precision of 98.30% and an average specificity of 98.23% for the CHB-MIT scalp EEG database. A comparison of the proposed model with other baseline methods was done to confirm the better performance of features through time-space nonlinear feature fusion. The results show that the proposed P3DCNN-BiConvLstm3D-Attention3D method for epilepsy prediction by time-space nonlinear feature fusion is effective.

Automatic and manual prediction of epileptic seizures based on ECG

Automatic and manual prediction of epileptic seizures based on ECG

Precise and low-power closed-loop neuromodulation through algorithm-integrated circuit co-design.

Implantable neuromodulation devices have significantly advanced treatments for neurological disorders such as Parkinson's disease, epilepsy, and depression. Traditional open-loop devices like deep brain stimulation (DBS) and spinal cord stimulators (SCS) often lead to overstimulation and lack adaptive precision, raising safety and side-effect concerns. Next-generation closed-loop systems offer real-time monitoring and on-device diagnostics for responsive stimulation, presenting a significant advancement for treating a range of brain diseases. However, the high false alarm rates of current closed-loop technologies limit their efficacy and increase energy consumption due to unnecessary stimulations. In this study, we introduce an artificial intelligence-integrated circuit co-design that targets these issues and using an online demonstration system for closed-loop seizure prediction to showcase its effectiveness. Firstly, two neural network models are obtained with neural-network search and quantization strategies. A binary neural network is optimized for minimal computation with high sensitivity and a convolutional neural network with a false alarm rate as low as 0.1/h for false alarm rejection. Then, a dedicated low-power processor is fabricated in 55 nm technology to implement the two models. With reconfigurable design and event-driven processing feature the resulting application-specific integrated circuit (ASIC) occupies only 5mm2 silicon area and the average power consumption is 142 μW. The proposed solution achieves a significant reduction in both false alarm rates and power consumption when benchmarked against state-of-the-art counterparts.

Comparison between epileptic seizure prediction and forecasting based on machine learning

Epilepsy affects around 1% of the population worldwide. Anti-epileptic drugs are an excellent option for controlling seizure occurrence but do not work for around one-third of patients. Warning devices employing seizure prediction or forecasting algorithms could bring patients new-found comfort and quality of life. These algorithms would attempt to detect a seizure’s preictal period, a transitional moment between regular brain activity and the seizure, and relay this information to the user. Over the years, many seizure prediction studies using Electroencephalogram-based methodologies have been developed, triggering an alarm when detecting the preictal period. Recent studies have suggested a shift in view from prediction to forecasting. Seizure forecasting takes a probabilistic approach to the problem in question instead of the crisp approach of seizure prediction. In this field of study, the triggered alarm to symbolize the detection of a preictal period is substituted by a constant risk assessment analysis. The present work aims to explore methodologies capable of seizure forecasting and establish a comparison with seizure prediction results. Using 40 patients from the EPILEPSIAE database, we developed several patient-specific prediction and forecasting algorithms with different classifiers (a Logistic Regression, a 15 Support Vector Machines ensemble, and a 15 Shallow Neural Networks ensemble). Results show an increase of the seizure sensitivity in forecasting relative to prediction of up to 146% and in the number of patients that displayed an improvement over chance of up to 300%. These results suggest that a seizure forecasting methodology may be more suitable for seizure warning devices than a seizure prediction one.

Continuous ambulatory epilepsy detection system incorporating feature engineering

Epilepsy is a prevailing disease that affects people from different age brackets and demographic backgrounds. It leads to uncontrollable onset of seizures and can result in severe neurological injuries. In this paper, we devised a novel seizure prediction system as a real-time early warning system for patients. By using real-time transmissible, portable, and wireless devices, we can acquire raw data from scalp electroencephalogram (EEG) without any pre-processing for the input. After pre-processing, the data is fed into selected prediction algorithms based on literature review and a combination of methodologies. After times of iteration, our result shows a promising performance, with an accuracy rate of 100% Bonn dataset. We further designed a hardware data acquisition apparatus (with our program built-in) to smooth and ameliorate the data acquisition process when eliminating overmuch electrodes, which may serve as a promising seizure onset detecting device in the new era.

Seizure prediction based on improved vision transformer model for EEG channel optimization

Epileptic seizures are unpredictable events caused by abnormal discharges of a patient’s brain cells. Extensive research has been conducted to develop seizure prediction algorithms based on long-term continuous electroencephalogram (EEG) signals. This paper describes a patient-specific seizure prediction method that can serve as a basis for the design of lightweight, wearable and effective seizure-prediction devices. We aim to achieve two objectives using this method. The first aim is to extract robust feature representations from multichannel EEG signals, and the second aim is to reduce the number of channels used for prediction by selecting an optimal set of channels from multichannel EEG signals while ensuring good prediction performance. We design a seizure-prediction algorithm based on a vision transformer (ViT) model. The algorithm selects channels that play a key role in seizure prediction from 22 channels of EEG signals. First, we perform a time-frequency analysis of processed time-series signals to obtain EEG spectrograms. We then segment the spectrograms of multiple channels into many non-overlapping patches of the same size, which are input into the channel selection layer of the proposed model, named Sel-JPM-ViT, enabling it to select channels. Application of the Sel-JPM-ViT model to the Boston Children’s Hospital–Massachusetts Institute of Technology scalp EEG dataset yields results using only three to six channels of EEG signals that are slightly better that the results obtained using 22 channels of EEG signals. Overall, the Sel-JPM-ViT model exhibits an average classification accuracy of 93.65%, an average sensitivity of 94.70% and an average specificity of 92.78%.

Biomimetic Deep Learning Networks With Applications to Epileptic Spasms and Seizure Prediction.

In this study, we present a novel biomimetic deep learning network for epileptic spasms and seizure prediction and compare its performance with state-of-the-art conventional machine learning models. Our proposed model incorporates modular Volterra kernel convolutional networks and bidirectional recurrent networks in combination with the phase amplitude cross-frequency coupling features derived from scalp EEG. They are applied to the standard CHB-MIT dataset containing focal epilepsy episodes as well as two other datasets from the Montefiore Medical Center and the University of California Los Angeles that provide data of patients experiencing infantile spasm (IS) syndrome. Overall, in this study, the networks can produce accurate predictions (100%) and significant detection latencies (10 min). Furthermore, the biomimetic network outperforms conventional ones by producing no false positives. Biomimetic neural networks utilize extensive knowledge about processing and learning in the electrical networks of the brain. Predicting seizures in adults can improve their quality of life. Epileptic spasms in infants are part of a particular seizure type that needs identifying when suspicious behaviors are noticed in babies. Predicting epileptic spasms within a given time frame (the prediction horizon) suggests their existence and allows an epileptologist to flag an EEG trace for future review.

An approach to detect and predict epileptic seizures with high accuracy using convolutional neural networks and single-lead-ECG signal

One of the epileptic patients’ challenges is to detect the time of seizures and the possibility of predicting. This research aims to provide an algorithm based on deep learning to detect and predict the time of seizure from one to two minutes before its occurrence. The proposed Convolutional Neural Network (CNN) can detect and predict the occurrence of focal epilepsy seizures through single-lead-ECG signal processing instead of using EEG signals. The structure of the proposed CNN for seizure detection and prediction is the same. Considering the requirements of a wearable system, after a few light pre-processing steps, the ECG signal can be used as input to the neural network without any manual feature extraction step. The desired neural network learns purposeful features according to the labelled ECG signals and then performs the classification of these signals. Training of 39-layer CNN for seizure detection and prediction has been done separately. The proposed method can detect seizures with an accuracy of 98.84% and predict them with an accuracy of 94.29%. With this approach, the ECG signal can be a promising indicator for the construction of portable systems for monitoring the status of epileptic patients.

A Deep Semi-Supervised Domain Generalization Approach for Epileptic Seizure Prediction using Electro Encephalo Graphy (EEG)

According to the World Health Organization, nearly 50 million people suffer from epilepsy, one of the most common neurological disease. Epilepsy is characterized by abnormal brain activity, leading to recurrent seizures. Each seizure manifests as sudden, uncontrolled bursts of electrical activity in the brain, and the injuries and restrictions on daily life underscores the urgency of finding effective methods for epileptic seizure prediction. With the use of deep learning techniques, early predictions of epileptic seizures, an unsolved problem, are attempted in this paper. Previous research has limitations of being sensitive to noise as it is dependent on specific electroencephalogram (EEG) devices and datasets, a serious issue this paper solves. In this paper, a semi-supervised based domain generalization method to develop an accurate seizure prediction system is proposed. It consists of two phases: representation learning and transfer learning phase. To achieve high precision, the proposed method utilizes a representation learning approach. Here, a feature-swapping mechanism that effectively disentangles seizure-related features is introduced. During transfer learning, the pre-trained network is trained to output the probability of whether the input EEG indicates a seizure or not. The proposed model achieves state-of-the-art performance, with an accuracy of 90.53% and 94.88% on the NICU and Epileptic Seizure Recognition datasets respectively in within-dataset evaluations. It outperforms the previous methods by 19.35% in cross-dataset evaluations. This robust improvement opens up promising possibilities for real-world clinical applications. The proposed feature disentangling method is also expected to contribute to developing reliable medical tools.

Stereotactic Electroencephalogram Recordings in Temporal Lobectomy Patients Demonstrates the Predictive Value of Interictal Cross-Frequency Correlations: A Retrospective Study.

Positive correlations between low- and high-frequency spectra from stereotactic electroencephalogram (SEEG) recordings have been implicated in pathological brain activity interictally and have been used for ictal detection in both focal and network models. We evaluated SEEG signals in patients who ultimately underwent temporal lobectomy to evaluate their utility in seizure localization and prediction of seizure freedom post-resection. We retrospectively analyzed cross-frequency correlations between beta and high gamma (HG) interictal SEEG signals from 22 patients. We compared signals based on temporal versus extra-temporal locations, seizure-free (SF) versus non-seizure-free (NSF) outcomes, and mesial (M) versus mesial temporal-plus (M+) onset. Positive cross-correlations were increased in temporal areas. NSF patients showed a higher proportion of positive electrodes in temporal areas. SF patients had a greater proportion of significant channels in mesial versus lateral temporal areas. HG/Beta correlations in mesial versus lateral temporal areas predicted seizure freedom better than ictal SEEG seizure onset localization to M or M+ locations. We present preliminary data that local HG/Beta correlations may predict epilepsy focus and surgical outcome and may have utility as adjunct methods to conventional SEEG analysis. Further studies are needed to determine strategies for prospective studies and clinical use.

Technological Vanguard: the outstanding performance of the LTY-CNN model for the early prediction of epileptic seizures

Background:Epilepsy is a common neurological disorder that affects approximately 60 million people worldwide. Characterized by unpredictable neural electrical activity abnormalities, it results in seizures with varying intensity levels. Electroencephalography (EEG), as a crucial technology for monitoring and predicting epileptic seizures, plays an essential role in improving the quality of life for people with epilepsy.Method:This study introduces an innovative deep learning model, a lightweight triscale yielding convolutional neural network” (LTY-CNN), that is specifically designed for EEG signal analysis. The model integrates a parallel convolutional structure with a multihead attention mechanism to capture complex EEG signal features across multiple scales and enhance the efficiency achieved when processing time series data. The lightweight design of the LTY-CNN enables it to maintain high performance in environments with limited computational resources while preserving the interpretability and maintainability of the model.Results:In tests conducted on the SWEC-ETHZ and CHB-MIT datasets, the LTY-CNN demonstrated outstanding performance. On the SWEC-ETHZ dataset, the LTY-CNN achieved an accuracy of 99.9%, an area under the receiver operating characteristic curve (AUROC) of 0.99, a sensitivity of 99.9%, and a specificity of 98.8%. Furthermore, on the CHB-MIT dataset, it recorded an accuracy of 99%, an AUROC of 0.932, a sensitivity of 99.1%, and a specificity of 93.2%. These results signify the remarkable ability of the LTY-CNN to distinguish between epileptic seizures and nonseizure events. Compared to other existing epilepsy detection classifiers, the LTY-CNN attained higher accuracy and sensitivity.Conclusion:The high accuracy and sensitivity of the LTY-CNN model demonstrate its significant potential for epilepsy management, particularly in terms of predicting and mitigating epileptic seizures. Its value in personalized treatments and widespread clinical applications reflects the broad prospects of deep learning in the health care sector. This also highlights the crucial role of technological innovation in enhancing the quality of life experienced by patients.

Supervised and Unsupervised Deep Learning Approaches for EEG Seizure Prediction.

Epilepsy affects more than 50 million people worldwide, making it one of the world's most prevalent neurological diseases. The main symptom of epilepsy is seizures, which occur abruptly and can cause serious injury or death. The ability to predict the occurrence of an epileptic seizure could alleviate many risks and stresses people with epilepsy face. We formulate the problem of detecting preictal (or pre-seizure) with reference to normal EEG as a precursor to incoming seizure. To this end, we developed several supervised deep learning approaches model to identify preictal EEG from normal EEG. We further develop novel unsupervised deep learning approaches to train the models on only normal EEG, and detecting pre-seizure EEG as an anomalous event. These deep learning models were trained and evaluated on two large EEG seizure datasets in a person-specific manner. We found that both supervised and unsupervised approaches are feasible; however, their performance varies depending on the patient, approach and architecture. This new line of research has the potential to develop therapeutic interventions and save human lives.

Domain adaptation for EEG-based, cross-subject epileptic seizure prediction.

The ability to predict the occurrence of an epileptic seizure is a safeguard against patient injury and health complications. However, a major challenge in seizure prediction arises from the significant variability observed in patient data. Common patient-specific approaches, which apply to each patient independently, often perform poorly for other patients due to the data variability. The aim of this study is to propose deep learning models which can handle this variability and generalize across various patients. This study addresses this challenge by introducing a novel cross-subject and multi-subject prediction models. Multiple-subject modeling broadens the scope of patient-specific modeling to account for the data from a dedicated ensemble of patients, thereby providing some useful, though relatively modest, level of generalization. The basic neural network architecture of this model is then adapted to cross-subject prediction, thereby providing a broader, more realistic, context of application. For accrued performance, and generalization ability, cross-subject modeling is enhanced by domain adaptation. Experimental evaluation using the publicly available CHB-MIT and SIENA data datasets shows that our multiple-subject model achieved better performance compared to existing works. However, the cross-subject faces challenges when applied to different patients. Finally, through investigating three domain adaptation methods, the model accuracy has been notably improved by 10.30% and 7.4% for the CHB-MIT and SIENA datasets, respectively.

Distilling Invariant Representations With Domain Adversarial Learning for Cross-Subject Children Seizure Prediction

Seizure prediction based on electroencephalogram (EEG) has great potential to improve patients’ life quality. Due to the high heterogeneity in distributions of EEG signals among different patients, conventional studies usually show poor generalization ability when transferring the model to new patients, which also leads to difficulties in clinical applications. To alleviate the challenging issue concerning cross-subject domain shift, we propose a transformer-based domain adversarial model. Our model first adopts a pre-trained general neural network to extract common features from the EEG signals of available patients. Then, we design a distiller module and a domain discriminator module to perform domain adaptation training based on a small amount of labeled data from the new-coming patient. During adaptation process, conditional domain adversarial training with the addition of label information is employed to remove patient-related information from the extracted features to learn a common seizure feature space among different patients. Our proposed seizure prediction method is evaluated on the CHB-MIT EEG database. The proposed model achieves a sensitivity of 79.5%, a false alarm rate (FPR) of 0.258/h, and an AUC of 0.814. Experimental results demonstrate that the proposed method can effectively reduce inter-patient domain disparity compared to state-of-the-art methods.

Abstract TMP62: The Delayed Seizure CVT Score Predicts Delayed Seizure After Cerebral Venous Thrombosis - A Secondary Analysis of ACTION-CVT

Introduction: Seizures are a common initial manifestation of cerebral venous thrombosis (CVT). We sought to establish predictive factors for delayed seizures to stratify risk and guide clinical management. Methods: We analyzed data from the Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with CVT from 2015 - 2020. The primary outcome was delayed seizure(s), occurring after 7 days from CVT diagnosis. Patients with outcome data for late seizures and follow-up of at least 7 days from time of diagnosis were included. Univariate analysis was performed using Chi-square, rank-sum, and t-tests. Variables with P-value < 0.2 were included in the backward stepwise regression model with 0.2 as cutoff, based on which we constructed the Delayed Seizure CVT (Delayed Seizures after CVT) score. Results: We identified 599 patients who met inclusion criteria: mean age 44.9(± 16.6) years, 62.9% female. Delayed seizures occurred in 37 (6.1%) patients. Risk factors included intracranial hemorrhage (OR 2.0 95% CI 0.7-5.74 p=0.196), alcohol abuse (OR 3.88 95% CI 1.45-10.38 p=0.007), focal neurologic deficit (OR 2.05 95% CI 0.95-4.44 p=0.067), seizure on presentation (OR 2.88 95% CI 1.32-6.29 p=0.008), hormonal birth control (OR 2.38 95% CI 1.06-5.37 p=0.0036), endovascular therapy (OR 2.86 95% CI 1.16-7.07 p=0.023) and decompressive hemicraniectomy (OR 3.357 95% CI 1.02-10.99 p=0.046), respectively. Based on coefficients of these variables, a 7-item score was created with acceptable performance for seizure prediction (AUC 0.796, 95% CI 0.72 - 0.86) (Table 1). Conclusions: Delayed seizure CVT score is a clinical tool to identify risk of delayed seizure in CVT. Further research is needed to validate these findings in an external cohort.