Predicting Post-Traumatic Epilepsy from Clinical Records using Large Language Model Embeddings

Post-traumatic epilepsy (PTE) is a severe complication of traumatic brain injury (TBI). Yet, early identification remains challenging due to the complex structural and functional alterations it induces in the brain. To address this, we propose a dynamic multimodal Mixture-of-Experts (MoE) framework that integrates functional and structural connectivity through time-aware functional-structural encoding and class-conditioned expert routing. Within this framework, modality-specific and cross-modal experts learn complementary representations, while a Modality-Class MoE (MCoE) module dynamically adjusts expert weights according to each classification objective. Experimental results across three binary classification tasks demonstrate that the framework consistently outperforms static fusion baselines, and high-interpretability analyses further reveal meaningful regions of interest (ROIs) interactions. This dynamic multimodal expert framework effectively captures class-dependent brain interaction patterns and provides an interpretable approach for PTE diagnosis and risk stratification.

Epilepsy is one of the most common neurological disorders globally, characterized by recurring seizures and significantly impacting the quality of life. Despite advancements in diagnostic techniques, the mitigation of risks faced by epilepsy patients remains challenging due to the unpredictability of seizure events. An accurate forecast of seizure onset helps to reduce risks in epilepsy patients. In this paper, we propose EEG-FuseFormer, a transformer-based feature fusion framework for seizure-onset prediction that combines intermediate features extracted from Convolutional Neural Networks-Long Short-Term Memory (CNN-LSTM) and ResNet-18 networks. The CNN-LSTM architecture captures both spatial and temporal features directly from the raw signal, whereas the ResNet-18 extracts features from the Short-Time Fourier Transform (STFT) representation of the EEG signals. Fusion is carried out using a transformer encoder, and the final prediction is generated using fully connected dense layers. The CHB-MIT dataset was used to validate the proposed model. The results show that the proposed model achieves a mean recall of 98.85% and outperforms most of the state-of-the-art methods. This study evaluates the ability of the proposed feature fusion model to generalize in cross-patient testing scenarios. Fine-tuning pre-trained models on limited target patient data (target adaptation) within the cross-patient validation framework results in higher recall, precision, and F1-score metrics in comparison to the conventional cross-patient validation approach. Finally, the runtime-based computational complexity of the model is assessed across diverse hardware platforms to highlight the performance-complexity trade-off.

We present Clin-JEPA, a multi-phase co-training framework for joint-embedding predictive (JEPA) pretraining on EHR patient trajectories. JEPA architectures have enabled latent-space planning in robotics and high-quality representation learning in vision, but extending the paradigm to EHR data -- to obtain a single backbone that simultaneously forecasts patient trajectories and serves diverse downstream risk-prediction tasks without per-task fine-tuning -- remains an open challenge. Existing JEPA frameworks either discard the predictor after pretraining (I-JEPA, V-JEPA) or train it on a frozen pretrained encoder (V-JEPA 2-AC), leaving the encoder unaware of the rollout signal that the retained predictor must use at inference; co-training the encoder and predictor under a shared JEPA prediction objective would supply this grounding, but naïve co-training is unstable, with representation collapse and online/target drift causing autoregressive rollout to diverge. Clin-JEPA's five-phase pretraining curriculum -- predictor warmup, joint refinement, EMA target alignment, hard sync, and predictor finalization -- addresses each failure mode by phase, stably co-training a Qwen3-8B-based encoder and a 92M-parameter latent trajectory predictor. On MIMIC-IV ICU data, three independent evaluations support the framework: (1) latent $\ell_1$ rollout drift uniquely converges ($-$15.7%) over 48-hour horizons while baselines and ablations diverge (+3% to +4951%); (2) the encoder learns a clinically discriminative latent geometry (deteriorating-patient cohorts displace 4.83$\times$ further than stable patients in latent space, vs $\leq$2.62$\times$ for baseline encoders); (3) a single backbone outperforms strong tabular and sequence baselines on multi-task downstream evaluation. Clin-JEPA achieves mean AUROC 0.851 on ICareFM EEP and 0.883 on 8 binary risk tasks (+0.038 and +0.041 vs baseline average).