RESUMO
Doose and Lennox-Gastaut (syndromes) are rare generalized electroclinical affections of early infancy of variable prognosis which manifest with very diverse kinds of seizures. Very frequently, these types of epilepsy become drug resistant and finding reliable treatment results is very difficult. As a result of this, fighting against these syndromes becomes a long term (or endless) event for the little patient, the neurologist and the parents. A lot of Electroencephalographic (EEG) records are so accumulated during the child's life in order to monitor evolution and correlate it with medications. So, given a bunch of EEG, three questions arise: (a) On which year was the child healthier (less affected by seizures)? (b) Which area of the brain has been the most affected? (c) What is the status of the child with respect to others (which also have a bunch of EEG, each)? Answering these interrogations by traditional scrutinizing of the whole database becomes subjective, if not impossible. We propose to answer these questions objectively by means of time series entropies. We start with our modified version of the Multiscale Entropy (MSE) in order to generalize it as a Bivariate MSE (BMSE) and from them, we compute two indices. All were tested in a series of patients and coincide with medical conclusions. As far as we are concerned, our contribution is new.
Assuntos
Encéfalo/fisiopatologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Eletroencefalografia/métodos , Epilepsias Mioclônicas/fisiopatologia , Síndrome de Lennox-Gastaut/fisiopatologia , Modelos Neurológicos , Adolescente , Algoritmos , Bases de Dados Factuais , Progressão da Doença , Entropia , Humanos , Processamento de Sinais Assistido por ComputadorRESUMO
Epilepsy demands a major burden at global levels. Worldwide, about 1% of people suffer epilepsy and 30% of them (0.3%) are anticonvulsants resistant. Among them, some children epilepsies are peculiarly difficult to deal with as Doose syndrome (DS). Doose syndrome is a very complicated type of children cryptogenic refractory epilepsy (CCRE) which is traditionally studied by analysis of complex electrencephalograms (EEG) by neurologists. CCRE are affections which evolve in a course of many years and customarily, questions such as on which year was the kid healthiest (less seizures) and on which region of the brain (channel) the affection has been progressing more negatively are very difficult or even impossible to answer as a result of the quantity of EEG recorded through the patient's life. These questions can now be answered by the application of entropies to massive information contained in many EEG. CCRE can not always be cured and have not been investigated from a mathematical viewpoint as far as we are concerned. In this work, a set of 80 time series (distributed equally in four yearly recorded EEG) is studied in order to support pediatrician neurologists to understand better the evolution of this syndrome in the long term. Our contribution is to support multichannel long term analysis of CCRE by observing simple entropy plots instead of studying long rolls of traditional EEG graphs. A comparative analysis among aproximate entropy, sample entropy, our versions of multiscale entropy (MSE) and composite multiscale entropy revealed that our refined MSE was the most convenient complexity measure to describe DS. Additionally, a new entropy parameter is proposed and is referred to as bivariate MSE (BMSE). Such BMSE will provide graphical information in much longer term than MSE.