用视觉语言对齐提升脑电图癫痫检测泛化能力

Automated seizure detection from electroencephalography (EEG) is essential for continuous neurological monitoring, particularly for subclinical epileptic seizures that may exhibit only subtle electrographic changes. Existing time-series methods are often designed for fixed EEG channel configurations, thereby limiting their applicability to heterogeneous EEG recordings with irregular channel layouts. Although visual and language modeling offer promising alternatives, aligning heterogeneous EEG representations with clinical semantics remains challenging. We introduce ViTexSZ, a heterogeneous Vision-Text knowledge distillation framework for EEG seizure detection. ViTexSZ converts EEG recordings into structured waveform images and introduces a query-based multi-channel alignment module that maps source-dependent visual features into a unified token space. A heterogeneous teacher further integrates the aligned EEG representations with clinical prompts through a multimodal large language model, associating high-level clinical semantics with seizure-related evidence. Vision-text knowledge distillation then transfers the teacher representations to a lightweight student during detection. Experiments on four EEG seizure datasets demonstrate the generalizability of ViTexSZ across both subclinical and general seizure detection scenarios, achieving the highest accuracy on all datasets and relative improvements of up to 12.9% over the second-best baselines, showing its effectiveness.