Monitorización prolongada por videoelectroencefalografía de pacientes con diagnóstico ambulatorio de epilepsia del lóbulo temporal de difícil control: aplicación del modelo de lógica fuzzy / Video-electroencephalography prolonged monitoring in patients with ambulatory diagnosis of medically refractory temporal lobe epilepsy: application of fuzzy logic’s model

Introducción. La monitorización prolongada por videoelectroencefalografía(vídeo-EEG) constituye un instrumento importantede auxilio al diagnóstico de epilepsia; facilita informacionesvaliosas con relación a la clasificación de los tipos de crisis ysíndromes epilépticos y la localización de la zona epileptógena. Lalógica fuzzy provee un método de análisis eficaz e inteligente,capaz de realizar inferencias sobre sistemas ambiguos y cada vezse utiliza más en diferentes áreas. Objetivos. Correlacionar datosclínicos y electroencefalográficos obtenidos por la monitorizaciónprolongada por vídeo-EEG de pacientes con diagnóstico en elambulatorio de epilepsia del lobo temporal (ELT) de difícil controle inferir los grados de precisión del diagnóstico por la aplicacióndel modelo COPPE/Cosenza de jerarquía fuzzy; investigar conqué frecuencia la monitorización puede corroborar o modificar eldiagnóstico clínico, sindrómico y topográfico de los pacientes estudiados;evaluar la utilidad y aplicabilidad de la lógica fuzzy en elanálisis de ese tipo de estudio. Pacientes y métodos. Estudio prospectivo,transversal, que incluye a 22 pacientes adultos con diagnósticoen el ambulatorio de ELT de difícil control, sometidos amonitorización por vídeo-EEG. Resultados. El diagnóstico clínicose modificó en dos pacientes (9%), el sindrómico en seis (27,2%), yel topográfico en 16 (72,7%). Los indicadores fuzzy de precisióndel diagnóstico en el ambulatorio fueron: 0,91 para diagnósticoclínico, 0,74 para diagnóstico sindrómico y 0,36 para diagnósticotopográfico; se considera 1 el valor de máxima precisión dediagnóstico (se atribuye a los resultados de la monitorización porvídeo-EEG). Conclusiones. La monitorización prolongada por vídeo-EEG estableció el diagnóstico clínico, sindrómico y topográficoen esos pacientes; la lógica fuzzy mostró definir mejor un valormatemático de la correspondencia entre el diagnóstico en el ambulatoriode ELT y la monitorización prolongada por vídeo-EEG

Introduction. The video-electroencephalography (video-EEG) prolonged monitoring is an important auxiliarydiagnostic instrument in epilepsy, and provides valuable information to classify the type of crisis and epileptic syndromes andto localize the epileptogenic zone. The fuzzy logic gives an efficient and intelligent analysis method, able to make inferencesover ambiguous systems, and has been increasing used in several areas. Aims. To correlate clinical and electroencephalographicdata obtained with video-EEG of patients with clinical and interictal electroencephalography criteria ofmedically refractory temporal lobe epilepsy (TLE) and to make inferences of diagnosis precision with the application of theFuzzy Hierarchy COPPE/Cosenza Model; to investigate the frequency in which the clinical, syndromic and topographicdiagnosis can be modified in these patients; to evaluate the usefulness and applicability of fuzzy logic on the analysis of thistype of study. Patients and methods. Transversal, prospective study, that included 22 adult outpatients with ambulatorydiagnosis of medically refractory TLE, submitted to video-EEG monitoring that varied from 48 hours to 10 days. The grade ofdiagnosis precision was infered by fuzzy logic. Results. The clinical diagnosis of epilepsy was modified in two (9%) patients,the syndromic in six (27.2%) and the topographic in 16 (72.7%). The fuzzy indicators of ambulatory diagnostic precisionwere: 0.91 to clinical diagnosis; 0.74 to syndromic diagnosis and 0.36 to topographic diagnosis, considering 1 the maximalprecision diagnostic value (attributed to the video-EEG results). Conclusions. The video-EEG prolonged monitoring establishedthe clinical, syndromic and topographic correct diagnosis in these patients; the fuzzy logic best defined a mathematical valueof the correspondence between ambulatorial diagnosis of TLE and the video-EEG prolonged monitoring

[Video-electroencephalography prolonged monitoring in patients with ambulatory diagnosis of medically refractory temporal lobe epilepsy: application of fuzzy logic's model]. / Monitorización prolongada por videoelectroencefalografía de pacientes con diagnóstico ambulatorio de epilepsia del lóbulo temporal de difícil control: aplicación del modelo de lógica fuzzy

INTRODUCTION: The video-electroencephalography (video-EEG) prolonged monitoring is an important auxiliary diagnostic instrument in epilepsy, and provides valuable information to classify the type of crisis and epileptic syndromes and to localize the epileptogenic zone. The fuzzy logic gives an efficient and intelligent analysis method, able to make inferences over ambiguous systems, and has been increasing used in several areas. AIMS: To correlate clinical and electroencephalographic data obtained with video-EEG of patients with clinical and interictal electroencephalography criteria of medically refractory temporal lobe epilepsy (TLE) and to make inferences of diagnosis precision with the application of the Fuzzy Hierarchy COPPE/Cosenza Model; to investigate the frequency in which the clinical, syndromic and topographic diagnosis can be modified in these patients; to evaluate the usefulness and applicability of fuzzy logic on the analysis of this type of study. PATIENTS AND METHODS: Transversal, prospective study, that included 22 adult outpatients with ambulatory diagnosis of medically refractory TLE, submitted to video-EEG monitoring that varied from 48 hours to 10 days. The grade of diagnosis precision was infered by fuzzy logic. RESULTS: The clinical diagnosis of epilepsy was modified in two (9%) patients, the syndromic in six (27.2%) and the topographic in 16 (72.7%). The fuzzy indicators of ambulatory diagnostic precision were: 0.91 to clinical diagnosis; 0.74 to syndromic diagnosis and 0.36 to topographic diagnosis, considering 1 the maximal precision diagnostic value (attributed to the video-EEG results). CONCLUSIONS: The video-EEG prolonged monitoring established the clinical, syndromic and topographic correct diagnosis in these patients; the fuzzy logic best defined a mathematical value of the correspondence between ambulatorial diagnosis of TLE and the video-EEG prolonged monitoring.