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Fig. 17.3: Long-term AED resetting of the brain dynamics in SE (Patient 2 - adult).
The effectiveness of AEDs on the patient's recovery is correlated well with the ex-
hibited trends of the average T-index of all entrained pairs of brain sites, selected
10 min before the beginning of the treatment of the patient with the first AED
(a scalp EEG dynamical analysis). The file vertical lines A through E mark the
beginning of these five available EEG segments for the dynamical analysis (the ex-
isting gaps in time between the files are not shown - the results from the dynamical
analysis of the files are concatenated in time). The dynamical analysis shows that
the patient was safe (high T-index values) and stable (high T-index values for a long
time) approximately 1 day following admission to the emergency room (beginning
of the record). The vertical green lines 1 through 5 denote the times of AED admin-
istration. Line 1 marks the completion of fosphenytoin infusion. Line 2 marks the
administration of fentanyl and etomidate. Line 3 marks administration of 50 mg of
propofol and the beginning of a 30 mcg/kg/min propofol infusion. Line 4 marks
a fosphenytoin 350 mg infusion and propofol administration at 50 mcg/kg/min.
Finally, line 5 marks where propofol is running at 35 mcg/kg/min. In the last EEG
recording available to us (file E), the patient remained off propofol.
of SE, the average T-index values remained high, denoting that the involved brain
sites remained disentrained. The correspondence of the T-index values and trends to
the changing medical condition of these patients over time is remarkable; T-index
values were low when AEDs failed, and high when they succeeded in getting the
patients out of SE.
17.4 Conclusion
We have shown a very good correlation of the measures derived by mathematical
analysis of EEG with the treatment efficacy of AEDs in stopping status epilepti-
cus. The above results indicate that the proposed measure/methodology, as well as
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