Mathematical Analysis of EEG of Patients with Non-fatal Nonspecific Diffuse Encephalitis
Diffuse viral encephalitis may lack fever and other cardinal signs of infection and hence its distinction from other acute encephalopathic illnesses is challenging. Often, the EEG changes seen routinely are nonspecific and reflect diffuse encephalopathic changes only. The aim of this study was to use nonlinear dynamic mathematical techniques for analyzing the EEG data in order to look for any characteristic diagnostic patterns in diffuse forms of encephalitis.It was diagnosed on clinical, imaging and cerebrospinal fluid criteria in three young male patients. Metabolic and toxic encephalopathies were ruled out through appropriate investigations. Digital EEGs were done on the 3rd to 5th day of onset. The digital EEGs of 5 male and 5 female age and sex matched healthy volunteers served as controls.Two sample t-test indicated that there was no statistically significant difference between the average values in amplitude between the two groups. However, the standard deviation (or variance) of the EEG signals at FP1-F7 and FP2-F8 are significantly higher for the patients than the normal subjects. The regularisation dimension is significantly less for the patients (average between 1.24-1.43) when compared to the normal persons (average between 1.41-1.63) for the EEG signals from all locations except for the Fz-Cz signal. Similarly the wavelet dimension is significantly less (P = 0.05*) for the patients (1.122) when compared to the normal person (1.458). EEGs are subdued in the case of the patients with presence of uniform patterns, manifested in the values of regularisation and wavelet dimensions, when compared to the normal person, indicating a decrease in chaotic nature.
<p>[1] A. Chaudhuri, and P. G. Kennedy, “Diagnosis and treatment of viral encephalitis," Postgrad Med J, vol. 78, pp. 575-583, 2002.
[2] J. B. Domachowske, et al.“Acute manifestations and neurologic sequelae of Epstein-Barr virus encephalitis in children," Pediatr Infect Dis J, vol. 15, pp. 871-875, 1996.
[3] V. V. Konomemko, “The clinical picture, diagnosis and treatment of cytomegalovirus encephalitis in adults," Lik Sprava, vol. 5, pp. 61-64, 1999.
[4] F. Ochikubo, et al., “Electroencephalogram and evoked potentials in the primate model of viral encephalitis," Electroencephalogr Clin Neurophysiol, vol. 88, pp. 397- 407, 1993.
[5] R. Gandelman-Marton, et al. “Electroencephalography findings in adult patients with West Nile virus-associated meningitis and meningoencephalitis," Clin Infect Dis, vol. 37, pp. 1573-1578, 2003.
[6] P. Cinque, et al., “The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis," J Neurol Neurosurg Psychiatry, vol. 61, pp. 339-345, 1996.
[7] J. Kalita, and U. K. Misra, “EEG in Japanese encephalitis: a clinicoradiological correlation," Electroencephalogr Clin Neurophysiol, vol.106, pp. 238-243, 1998.
[8] O. N. Markand, “Electroencephalography in diffuse encephalopathies," J Clin Neurophysiol, vol. 1, pp. 357- 407, 1984.
[9] Rachel Straussberg, Liora Harel, Yael Levy, and Jacob Amir, “A syndrome of transient encephalopathy associated with adenovirus infection," Pediatrics, vol. 107, pp. E69, 2001.
[10] American Electroencephalographic Society, “Guideline fourteen: guidelines for recording clinical EEG on digital media," J Clin Neurophysiol, vol. 11, pp. 114-115, 1994.
[11] American Society of Electroneurodiagnostic Technologists, “Waveform Window," Am J Electroneurodiagnostic Technol, vol.45, pp. 145-149, 2005.
[12] N. Kannathal, U. R. Acharya, C. M. Lim, and P. M. Sadasivan, “Characterization of EEG-a comparative study," Computer methods and Programs in Biomedicine, vol. 80, pp. 17-23, 2005.
[13] R. Ferri, et al., “Scalp topographic distribution of beta and gamma ratios during sleep," J of Psychophysiology, vol.16, pp. 107-113, 2002.
[14] A. Graps, An Introduction to Wavelets, IEEE Computational Science and Engineering. Los Alamitos, CA: IEEE Computer Society, 1995, vol. 2.
[15] Q. Guo, J. Shao and V. Ruiz, “Investigation of support vector machine for the detection of architectural distortion in mammographic images," Journal of Physics: Conference Series, vol. 15, pp. 88-94, 2005.
[16] B. Migdalska-Kassurowa, “Electroencephalographic changes in patients with arbovirus infections," Pol Tyg Lek, vol. 31, pp. 437- 440, 1976.
[17] N. Sofijanov, M. Dukovski, and A. Sadikario. “Development of EEG changes in subacute leukoencephalitis," God Zb Med Fak Skopje, vol. 23, pp. 729-738, 1977.
[18] K. R. Brinker, G. Paulson, T. P. Monath, G. Wise, and R. J. Fass, “St Louis encephalitis in Ohio, September 1975: clinical and EEG studies in 16 cases," Arch Intern Med, vol.139, pp. 561- 566, 1979.
[19] C. G├╝rses, et al. “Correlation between clinical stages and EEG findings of subacute sclerosing panencephalitis," Clin Electroencephalogr, vol. 31, pp. 201-206, 2000.
[20] A. Panagariya, et al., “Herpes simplex encephalitis in North West India," Neurol India, vol. 49, pp. 360-365, 2001.
[21] H. Yoshikawa, S. Yamazaki, T. Watanabe, and T. Abe, “Study of influenza-associated encephalitis/encephalopathy in children during the 1997 to 2001 influenza seasons," J Child Neurol, vol. 16, pp. 885- 890, 2001.
[22] U. K. Misra, J. Kalita, D. Goel, and A. Mathur, “Clinical, radiological and neurophysiological spectrum of JEV encephalitis and other nonspecific encephalitis during post-monsoon period in India," Neurol India, vol. 51, pp. 55-59, 2003.
[23] O. Kentaro, F. Mitsumasa, S. Ritsuko, and T. Tomohiko, “Two cases of acute encephalitis/encephalopathy associated with adenovirus type 3 infections," No To Hattatsu, vol. 36, pp. 487-491, 2004.
[24] S. F. Mekan, et al., “Herpes simplex encephalitis: analysis of 68 cases from a tertiary care hospital in Karachi, Pakistan," J Pak Med Assoc, vol. 55, pp. 146-148, 2005.
[25] Y. J. Lee, et al., “Detection of non-linearity in the EEG of schizophrenic patients," Clinical Neurophysiology, vol. 112, pp. 1288-1294, 2001.
[26] D. Abasolo, R. Hornero, C. G├│mez, M. Garc├¡a, and M. L├│pez, “Analysis of EEG background activity in Alzheimer's disease patients with Lempel-Ziv complexity and central tendency measure," Medical Engineering & Physics, vol.28, pp. 315-322, 2006.
[27] T. Yambe, et al., “Chaos analysis of electro encephalography and control of seizure attack of epilepsy patients," Biomedicine and pharmacotherapy, vol. 59, pp. S236-S238, 2005.
[28] M. S. Keshavan, J. D. Cashmere, J. Miewald, and V. K. Yeragni, “Decreased nonlinear complexity and chaos during sleep in first episode schizophrenia: a preliminary report," Schizophrenia research, vol. 71, pp. 263-272, 2004.
[29] T. C. Ferree, and R. C. Hwa, “Power-law scaling in human EEG: Relation to Fourier power spectrum," Neurocomputing, vol.52, pp. 755- 761, 2003.
[30] R. Ferri, M. Elia, S. A. Musumeci, and C. J. Stam, “Non-linear EEG analysis in children with epilepsy and electrical status epilepticus during slow-wave sleep (ESES)," Clinical Neurophysiology, vol. 112, pp. 2274- 2280, 2001.
[31] D. Mukesh, and R. Nadkar, “Neural network modeling of human EEG patterns," Current Sci, vol.72, pp. 261-265, 1997.</p>
<p>[1] A. Chaudhuri, and P. G. Kennedy, “Diagnosis and treatment of viral encephalitis," Postgrad Med J, vol. 78, pp. 575-583, 2002.
[2] J. B. Domachowske, et al.“Acute manifestations and neurologic sequelae of Epstein-Barr virus encephalitis in children," Pediatr Infect Dis J, vol. 15, pp. 871-875, 1996.
[3] V. V. Konomemko, “The clinical picture, diagnosis and treatment of cytomegalovirus encephalitis in adults," Lik Sprava, vol. 5, pp. 61-64, 1999.
[4] F. Ochikubo, et al., “Electroencephalogram and evoked potentials in the primate model of viral encephalitis," Electroencephalogr Clin Neurophysiol, vol. 88, pp. 397- 407, 1993.
[5] R. Gandelman-Marton, et al. “Electroencephalography findings in adult patients with West Nile virus-associated meningitis and meningoencephalitis," Clin Infect Dis, vol. 37, pp. 1573-1578, 2003.
[6] P. Cinque, et al., “The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis," J Neurol Neurosurg Psychiatry, vol. 61, pp. 339-345, 1996.
[7] J. Kalita, and U. K. Misra, “EEG in Japanese encephalitis: a clinicoradiological correlation," Electroencephalogr Clin Neurophysiol, vol.106, pp. 238-243, 1998.
[8] O. N. Markand, “Electroencephalography in diffuse encephalopathies," J Clin Neurophysiol, vol. 1, pp. 357- 407, 1984.
[9] Rachel Straussberg, Liora Harel, Yael Levy, and Jacob Amir, “A syndrome of transient encephalopathy associated with adenovirus infection," Pediatrics, vol. 107, pp. E69, 2001.
[10] American Electroencephalographic Society, “Guideline fourteen: guidelines for recording clinical EEG on digital media," J Clin Neurophysiol, vol. 11, pp. 114-115, 1994.
[11] American Society of Electroneurodiagnostic Technologists, “Waveform Window," Am J Electroneurodiagnostic Technol, vol.45, pp. 145-149, 2005.
[12] N. Kannathal, U. R. Acharya, C. M. Lim, and P. M. Sadasivan, “Characterization of EEG-a comparative study," Computer methods and Programs in Biomedicine, vol. 80, pp. 17-23, 2005.
[13] R. Ferri, et al., “Scalp topographic distribution of beta and gamma ratios during sleep," J of Psychophysiology, vol.16, pp. 107-113, 2002.
[14] A. Graps, An Introduction to Wavelets, IEEE Computational Science and Engineering. Los Alamitos, CA: IEEE Computer Society, 1995, vol. 2.
[15] Q. Guo, J. Shao and V. Ruiz, “Investigation of support vector machine for the detection of architectural distortion in mammographic images," Journal of Physics: Conference Series, vol. 15, pp. 88-94, 2005.
[16] B. Migdalska-Kassurowa, “Electroencephalographic changes in patients with arbovirus infections," Pol Tyg Lek, vol. 31, pp. 437- 440, 1976.
[17] N. Sofijanov, M. Dukovski, and A. Sadikario. “Development of EEG changes in subacute leukoencephalitis," God Zb Med Fak Skopje, vol. 23, pp. 729-738, 1977.
[18] K. R. Brinker, G. Paulson, T. P. Monath, G. Wise, and R. J. Fass, “St Louis encephalitis in Ohio, September 1975: clinical and EEG studies in 16 cases," Arch Intern Med, vol.139, pp. 561- 566, 1979.
[19] C. G├╝rses, et al. “Correlation between clinical stages and EEG findings of subacute sclerosing panencephalitis," Clin Electroencephalogr, vol. 31, pp. 201-206, 2000.
[20] A. Panagariya, et al., “Herpes simplex encephalitis in North West India," Neurol India, vol. 49, pp. 360-365, 2001.
[21] H. Yoshikawa, S. Yamazaki, T. Watanabe, and T. Abe, “Study of influenza-associated encephalitis/encephalopathy in children during the 1997 to 2001 influenza seasons," J Child Neurol, vol. 16, pp. 885- 890, 2001.
[22] U. K. Misra, J. Kalita, D. Goel, and A. Mathur, “Clinical, radiological and neurophysiological spectrum of JEV encephalitis and other nonspecific encephalitis during post-monsoon period in India," Neurol India, vol. 51, pp. 55-59, 2003.
[23] O. Kentaro, F. Mitsumasa, S. Ritsuko, and T. Tomohiko, “Two cases of acute encephalitis/encephalopathy associated with adenovirus type 3 infections," No To Hattatsu, vol. 36, pp. 487-491, 2004.
[24] S. F. Mekan, et al., “Herpes simplex encephalitis: analysis of 68 cases from a tertiary care hospital in Karachi, Pakistan," J Pak Med Assoc, vol. 55, pp. 146-148, 2005.
[25] Y. J. Lee, et al., “Detection of non-linearity in the EEG of schizophrenic patients," Clinical Neurophysiology, vol. 112, pp. 1288-1294, 2001.
[26] D. Abasolo, R. Hornero, C. G├│mez, M. Garc├¡a, and M. L├│pez, “Analysis of EEG background activity in Alzheimer's disease patients with Lempel-Ziv complexity and central tendency measure," Medical Engineering & Physics, vol.28, pp. 315-322, 2006.
[27] T. Yambe, et al., “Chaos analysis of electro encephalography and control of seizure attack of epilepsy patients," Biomedicine and pharmacotherapy, vol. 59, pp. S236-S238, 2005.
[28] M. S. Keshavan, J. D. Cashmere, J. Miewald, and V. K. Yeragni, “Decreased nonlinear complexity and chaos during sleep in first episode schizophrenia: a preliminary report," Schizophrenia research, vol. 71, pp. 263-272, 2004.
[29] T. C. Ferree, and R. C. Hwa, “Power-law scaling in human EEG: Relation to Fourier power spectrum," Neurocomputing, vol.52, pp. 755- 761, 2003.
[30] R. Ferri, M. Elia, S. A. Musumeci, and C. J. Stam, “Non-linear EEG analysis in children with epilepsy and electrical status epilepticus during slow-wave sleep (ESES)," Clinical Neurophysiology, vol. 112, pp. 2274- 2280, 2001.
[31] D. Mukesh, and R. Nadkar, “Neural network modeling of human EEG patterns," Current Sci, vol.72, pp. 261-265, 1997.</p>
@article{"International Journal of Medical, Medicine and Health Sciences:50096", author = "Mukesh Doble and Sunil K Narayan", title = "Mathematical Analysis of EEG of Patients with Non-fatal Nonspecific Diffuse Encephalitis ", abstract = "Diffuse viral encephalitis may lack fever and other cardinal signs of infection and hence its distinction from other acute encephalopathic illnesses is challenging. Often, the EEG changes seen routinely are nonspecific and reflect diffuse encephalopathic changes only. The aim of this study was to use nonlinear dynamic mathematical techniques for analyzing the EEG data in order to look for any characteristic diagnostic patterns in diffuse forms of encephalitis.It was diagnosed on clinical, imaging and cerebrospinal fluid criteria in three young male patients. Metabolic and toxic encephalopathies were ruled out through appropriate investigations. Digital EEGs were done on the 3rd to 5th day of onset. The digital EEGs of 5 male and 5 female age and sex matched healthy volunteers served as controls.Two sample t-test indicated that there was no statistically significant difference between the average values in amplitude between the two groups. However, the standard deviation (or variance) of the EEG signals at FP1-F7 and FP2-F8 are significantly higher for the patients than the normal subjects. The regularisation dimension is significantly less for the patients (average between 1.24-1.43) when compared to the normal persons (average between 1.41-1.63) for the EEG signals from all locations except for the Fz-Cz signal. Similarly the wavelet dimension is significantly less (P = 0.05*) for the patients (1.122) when compared to the normal person (1.458). EEGs are subdued in the case of the patients with presence of uniform patterns, manifested in the values of regularisation and wavelet dimensions, when compared to the normal person, indicating a decrease in chaotic nature.
", keywords = "Chaos, Diffuse encephalitis,Electroencephalogram, Fractal dimension, Fourier spectrum.", volume = "1", number = "2", pages = "43-7", }
