Monitoring and diagnosing neonatal seizures by video signal processing

Abstract

Clinical operators in one of the most difficult health care fields, namely neonatal neurology, on a daily basis have to face the diagnosis of epileptic seizures. Most of the neonates affected by perinatal diseases are at risk of neonatal seizures, which are the most common sign of acute neurological dysfunctions and must be promptly and accurately recognized in order to establish timely treatments. Traditional diagnostic methods are based on ElectroEncephaloGraphic (EEG) monitoring. The neonatal EEG analysis is, however, a very specialistic and time-consuming technique which requires particular skills not always easily available in Neonatal Intensive Care Units (NICUs). Therefore, non-invasive, real-time, automated, low-cost, wide-scale diagnostic methods and equipments capable of reliably recognizing neonatal seizures would be of significant value in the NICUs.

Whilst the importance of promptly diagnosing the presence of neonatal seizures is clear, there are no actual methods to early recognize or detect such pathological behaviors, nor currently available instruments to predict them. The only available and reliable method is the EEG, which is moderately invasive and needs well-trained medical personnel to be correctly administered and interpreted.

A very appealing alternative, with respect to the EEG, to automatically detect the presence of seizures consists in acquiring, through a video camera, the movements of the newborn's body and properly processing the relevant video signal. The goal of an effective image processing algorithm is the detection of “unusual” movements of the newborn. The aim of automatic detection and classification of neonatal seizures through a video camera is not to completely replace the EEG (still required for accurate diagnosis), but to make an immediate low-cost preliminary diagnosis based on clinical aspects of neonatal seizures. In other words, an automatic video camera-based system could be used to permanently monitor every patient in the neonatal care unit, whereas the EEG would be required for a definitive diagnosis only when the system indicates, with high probability, the potential presence of seizures.