Detecting seizure onset and offset times using human intelligence: A critical-transitions-based approach

Despite strong performance on held-out electroencephalography (EEG) data, seizure detectors may fail under real-world acquisition variability, artifacts, and adversarial inputs. We introduce RobustSeiz, an open-source, model-agnostic framework that provides a standardized, reproducible protocol for stress-testing and comparing seizure detectors under controlled, clinically motivated distribution shifts before deployment. We standardize four public scalp-EEG corpora (CHB-MIT, TUSZ, Siena, and SeizeIT1) into BIDS-EEG trees and evaluate subject-independent detectors on held-out splits. Environment, noise, and adversarial transforms are swept over predefined hyperparameter grids. Each run reports sample- and event-level sensitivity, precision, F1, false positives per 24 h, Lead and Lag onset timing, and Monte Carlo dropout predictive agreement. RobustSeiz includes a Dockerized GPU pipeline, experiment registry, and full-evaluation and research-subset modes. We demonstrate the framework with a contemporary seizure detector on TUSZ across the complete implemented shift grid; an AWGN analysis illustrates how perturbation severity changes detection quality, onset timing, and predictive agreement. RobustSeiz provides a shared benchmarking standard for evaluating seizure-detector robustness under realistic clinical stressors, extending pre-deployment assessment beyond clean-data accuracy.

Reliable seizure detection in mouse models is essential for preclinical epilepsy research, yet manual review of synchronized video-EEG recordings is labor-intensive and single-modality systems fail for complementary reasons: video-based methods are easily confounded by benign behaviors, whereas EEG-based methods are vulnerable to ictal motion artifacts. We present EEGVFusion, a multimodal framework that combines self-supervised EEG representation learning, spatio-temporal video encoding, optimal-transport alignment, and bidirectional cross-attention to integrate neural and behavioral evidence. We also curate an expert-annotated dataset of synchronized EEG and video recordings comprising 93 sessions from 15 mice for training and evaluation. In the random-session split, EEGVFusion achieved a Balanced Accuracy of 0.9957 with perfect event sensitivity and an Event FAR of 0.6250 FP/h, indicating strong seizure detection performance with a low false-alarm burden. In a single held-out-subject evaluation with Subject 110 reserved for testing, EEGVFusion achieved a Balanced Accuracy of 0.9718 and reduced Event FAR from 2.7250 FP/h for the EEG-only counterpart to 0.4833 FP/h while preserving perfect event sensitivity. Targeted ablations further showed that EEG pre-training and OT alignment help reduce false alarms while preserving event sensitivity.

Deep learning for EEG-based seizure detection faces critical challenges: severe annotation scarcity and extreme class imbalance, where ictal events comprise less than 10% of clinical recordings. We present DiffEEG, a 9.6M-parameter self-supervised foundation model that addresses both limitations through denoising diffusion pre-training and reinforcement learning (RL)-based fine-tuning. Pre-trained on 1.3M unlabeled segments from the Temple University Hospital Seizure Corpus (TUHSZ), DiffEEG learns generic neural representations via a 1D U-Net with multi-head self-attention. For downstream adaptation, a reinforced decision layer employs policy gradient optimization to directly maximize F1-score, prioritizing sensitivity to rare seizure events over overall accuracy. Under strict patient-wise evaluation (279 patients, Leave-One-Fold-Out), DiffEEG achieves 61% accuracy and 59% F1 for 4-class seizure subtyping, and 81% accuracy with 85% weighted F1 for binary detection, maintaining clinically viable seizure recall (59%) despite extreme imbalance (6.7% prevalence). Segment-level evaluation establishes an upper bound of 97.6% accuracy, confirming strong architectural capacity. DiffEEG demonstrates that diffusion-based pre-training combined with metric-aware reinforcement learning enables clinically deployable seizure monitoring with minimal labeled data requirements.