Medical systems and methods for detecting changes in electrophysiological evoked potentials

An automated electrical waveforms (EPs) analysis system for improved monitoring, detecting and identifying changes to a patient's physiological system, wherein the system comprises:

• an input device for obtaining electrical potential data from the patient's physiological system after application of stimulation to a patient's nerve pathway;
• at least one processor;
• and
• at least one memory storing instructions which, when executed by the at least one processor, result in operations comprising:
• causing stimulation of a nerve pathway of a patient with electrical pulses via electrodes placed over the nerve pathway to generate a plurality of resultant electrical waveforms (EPs) based on a plurality of electrophysiological responses (ERs);
• recording the plurality of resultant EPs;
• generating an ensemble average waveform (EA), the generating comprising averaging a subset of the plurality of ERs;
• denoising the EA to generate a denoised EA comprising a denoised signal, the denoising comprising:
• decomposing, hierarchically, the EA using a series of filter banks, wherein filter coefficients of the series of filter banks used in the hierarchical decomposition are derived from a mother wavelet, and wherein the decomposing comprises applying a first wavelet transform;
• iterating the hierarchical decomposition of the EA, the hierarchical decomposition of the EA filtering high-frequency noise from the EA;
• applying a dynamic coefficient threshold to the filter coefficients, the dynamic coefficient threshold determined with each EA;
• and
• applying a second wavelet transform to the EA, the second wavelet transform comprising an inverse wavelet transform using the mother wavelet;
• comparing the denoised EA to a previously denoised EA;
• determining whether a change has occurred in the denoised EA relative to the previously denoised EA;
• and
• generating, based on the determination that the change has occurred, an alert.