Abstract Epilepsy is a common neurological disorder that sub-stantially deteriorates patients’ safety and quality of life. Electroencephalogram (EEG) has been the golden-standard technique for diagnosing this brain disorder and has played an essential role in epilepsy monitoring and disease management. It is extremely laborious and challenging, if not practical, for physicians and expert humans to annotate all recorded signals, particularly in long-term monitoring. The annotation process often involves identifying signal segments with suspected epileptic seizure features or other abnormalities and/or known healthy features. Therefore, automated epilepsy detection becomes a key clinical need because it can greatly improve clinical practice’s efficiency and free up human expert time to attend to other important tasks. Current automated seizure detection algorithms generally face two challenges: (1) models trained for specific patients, but such models are patient-specific, hence fail to generalize to other patients and real-world situations; (2) seizure detection models trained on large EEG datasets have low sensitivity and/or high false positive rates, often with an area under the receiver operating characteristic (AUROC) that is not high enough for potential clinical applicability. This paper proposes Transformers for Seizure Detection, which we refer to as TSD in this manuscript. A Transformer is a deep learning architecture based on an encoder-decoder structure and on attention mechanisms, which we apply to recorded brain signals. The AUROC of our proposed model has achieved 92.1%, tested with Temple University’s publically available electroencephalogram (EEG) seizure corpus dataset (TUH). Additionally, we highlight the impact of input domains on the model’s performance. Specifically, TSD performs best in identifying epileptic seizures when the input domain is a time-frequency. Finally, our proposed model for seizure detection in inference-only mode with EEG recordings shows outstanding performance in classifying seizure types and superior model initialization.

TSD: Transformers for Seizure Detection