Automated diagnosis of encephalitis in pediatric patients using EEG rhythms and slow biphasic complexes
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SCIENTIFIC PAPER
Automated diagnosis of encephalitis in pediatric patients using EEG rhythms and slow biphasic complexes Luca Mesin1 · Massimo Valerio1 · Giorgio Capizzi2 Received: 11 April 2020 / Accepted: 29 June 2020 © Australasian College of Physical Scientists and Engineers in Medicine 2020
Abstract Slow biphasic complexes (SBC) have been identified in the EEG of patients suffering for inflammatory brain diseases. Their amplitude, location and frequency of appearance were found to correlate with the severity of encephalitis. Other characteristics of SBCs and of EEG traces of patients could reflect the grade of pathology. Here, EEG rhythms are investigated together with SBCs for a better characterization of encephalitis. EEGs have been acquired from pediatric patients: ten controls and ten encephalitic patients. They were split by neurologists into five classes of different severity of the pathology. The relative power of EEG rhythms was found to change significantly in EEGs labeled with different severity scores. Moreover, a significant variation was found in the last seconds before the appearance of an SBC. This information and quantitative indexes characterizing the SBCs were used to build a binary classification decision tree able to identify the classes of severity. True classification rate of the best model was 76.1% (73.5% with leave-one-out test). Moreover, the classification errors were among classes with similar severity scores (precision higher than 80% was achieved considering three instead of five classes). Our classification method may be a promising supporting tool for clinicians to diagnose, assess and make the follow-up of patients with encephalitis. Keywords EEG · EEG rhythms · Encephalitis · Slow biphasic complex · Binary classification decision tree
Introduction Encephalitis reflects a brain inflammation associated with neurological problems [21, 40, 52, 57]. In children, its incidence is about 1 out of 10,000 [59]. The lethal rate is high: for example, encephalitis by herpes simplex (i.e., the most common etiologic agent) has a mortality rate in the order of 5–20% (which rises to 70% if an antiviral treatment is not applied [12]). Encephalitis can be caused by infectious diseases, immune disorders, vascular pathology or cancer * Luca Mesin [email protected] Massimo Valerio [email protected] Giorgio Capizzi [email protected] 1
Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
Ospedale Infantile Regina Margherita, Department of Child Neuropsychiatry, Universitá di Torino, Turin, Italy
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[5]. The rapid diagnosis of the pathology is of primary importance to reduce deleterious consequences [5, 31, 40]. However, its assessment is mostly subjective, based on the integration of many clinical observations (e.g., about body temperature and level of consciousness) and measurements (e.g., imaging, blood tests, analysis of the cerebrospinal fluid). The EEG was fou
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