Multifractal Approach for Quantification of Autonomic Deregulation Due to Epileptic Seizure with ECG Data



Since the autonomic function affecting the sympathetic, parasympathetic nervous system changes due to epileptic seizure, the corresponding changes in cardiac signals may be effectively used as potential biomarker providing an extracerebral indicator of ictal onset in some cases. Patients suffering from epilepsy may experience serious cardiac malfunctions leading to sudden unexpected death (SUDEP). Thus the heart rate fluctuations during seizure are non-linear and extremely complex. This chapter presents a report on the analysis of ECG signals of postictal patients using a modern and rigorous chaos-based non-linear technique.


  1. Al-Aweel IC, Krishnamurthy KB, Hausdorff JM, Mietus JE, Ives JR et al (1999) Post-ictal heart rate oscillations in partial epilepsy. Neurology 53:1590–1592PubMedCrossRefGoogle Scholar
  2. Amaral LAN, Ivanov PC, Aoyagi N, Hidaca I, Tomono S et al (2001) Behavioral-independent features of complex heartbeat dynamics. Phys Rev Lett 86:6026CrossRefGoogle Scholar
  3. Amaranth M (2010) Diagnosis of post-ictal heart oscillations in partial epilepsy using power spectral density analysis. ICCAE 2nd Int Conf Singapore, IEEE 3:333–336Google Scholar
  4. Ansakorpi H, Korpelainen JT, Suominen K, Tolonen U, Myllyla VV et al (2000) Interictal cardiovascular autonomic responses in patients with temporal lobe epilepsy. Epilepsia 41:42–47PubMedCrossRefGoogle Scholar
  5. Ansakorpi H, Korpelainen JT, Huikuri HV, Tolonen U, Myllyla VV et al (2002) Heart rate dynamics in refractory and well controlled temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 72:26–30PubMedPubMedCentralCrossRefGoogle Scholar
  6. Ashkenazy Y, Baker DR, Gildor H, Havlin S (2003) Non-linearity and multifractality of climate change in the past 420,000 years. Geophys Res Lett 30:2146–2149CrossRefGoogle Scholar
  7. Baumgartner C, Lurger S, Leutmezer F (2001) Autonomic symptoms during epileptic seizures. Epileptic Disord 3:103–116PubMedGoogle Scholar
  8. Berilgen MS, Sari T, Bulut S, Mungen B (2004) Effects of epilepsy on autonomic nervous system and respiratory function tests. Epilepsy Behav 5:513–516PubMedCrossRefGoogle Scholar
  9. Bernaola GP, Ivanov PC, Amaral LA, Stanley HE (2001) Scale invariance in the non-stationarity of human heart rate. Phys Rev Lett 87:168105–168109CrossRefGoogle Scholar
  10. Blumhardt LD, Smith PEM, Owen L (1986) Electrocardiographic accompaniments of temporal lobe epileptic seizures. Lancet 1:1051–1056PubMedCrossRefGoogle Scholar
  11. Britton JW, Ghearing GR, Benarroch EE, Cascino GD (2006) The ictal bradycardia syndrome: localization and lateralization. Epilepsia 47:737–744PubMedCrossRefGoogle Scholar
  12. Brouwer J, van Veldhuisen DJ, Veld AJMI (1996) Prognostic value of heart rate variability during long-term follow-up in patients with mild to moderate heart failure. J Am Coll Cardiol 28:1183–1189PubMedCrossRefGoogle Scholar
  13. Chhabra A, Jensen RV (1989) Direct determination of the f(α) singularity spectrum. Phys Rev Lett 62:1327–1330PubMedCrossRefGoogle Scholar
  14. Chroni E, Sirrou V, Trachani E, Sakellaropoulos GC, Polychronopoulos P (2008) Interictal alterations of cardiovagal function in chronic epilepsy. Epilepsy Res 83(2–3):117–123PubMedGoogle Scholar
  15. Coenen AJ, Rompelman O, Kitney RI (1977) Measurement of heart-rate variability: part 2-hardware digital device for the assessment of heart-rate variability. Med Biol Eng Comput 15:423–430PubMedCrossRefGoogle Scholar
  16. Daniellson BR, Lansdell K, Patmore L, Tomson T (2005) Effects of the antiepileptic drugs lamotrigine, topiramate and gabapentin on hERG potassium currents. Epilepsy Res 63:17–25CrossRefGoogle Scholar
  17. Dasheiff RM, Dickinson LJ (1986) Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure. Arch Neurol 43:194–196PubMedCrossRefGoogle Scholar
  18. De Ferrari GM, Sanzo A, Schwartz PJ (2009) Chronic vagal stimulation in patients with congestive heart failure. Conf Proc IEEE Eng Med Biol Soc 2009:2037–2039PubMedGoogle Scholar
  19. Di Gennaro G, Quarato PP, Sebastiano F, Esposito V, Onorati P, Grammaldo LG et al (2004) Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures. Clin Neurophysiol 115:1169–1177PubMedCrossRefGoogle Scholar
  20. Dutta S (2010) Multifractal properties of ECG patterns of patient suffering from congestive heart failure. J Stat Mech Theory Exp P12021Google Scholar
  21. Elmpt WJCV, Nijsen TME, Griep PAM, Arends JBAM (2006) A model of heart rate changes to detect seizures in severe epilepsy. Seizure 15:366–375PubMedCrossRefGoogle Scholar
  22. Fakhouri SY (1980) Identification of Volterra kernels of non-linear discrete system. IEEE Proc D Contr Theor Appl 127:296–304CrossRefGoogle Scholar
  23. Fogarasi A, Janszky J, Tuxhorn I (2006) Autonomic symptoms during childhood partial epileptic seizures. Epilepsia 47:584–588PubMedCrossRefGoogle Scholar
  24. Foldvary-Schaefer N, Unnwongse K (2011) Localizing and lateralizing features of auras and seizures. Epilepsy Behav 20:160–166PubMedCrossRefGoogle Scholar
  25. Fortrat JO, Yamamoto Y, Hughson RL (1997) Respiratory influences on non-linear dynamics of heart rate variability in humans. Biol Cybern 77:1–10PubMedCrossRefGoogle Scholar
  26. Galaska R, Makowiec D, Dudkowska A, Koprowski A, Fijalkowski M et al (2007) Multifractal properties of heart rate by multifractal detrended fluctuation analysis and wavelet transform modulus maxima analysis—are both approaches equivalent? J Electrocardiol 40:S41–S42CrossRefGoogle Scholar
  27. Galaska R, Makowiec D, Dudkowska A, Koprowski A, Chlebus K et al (2008) Comparison of wavelet transform modulus maxima and multifractal detrended fluctuation analysis of heart rate in patients with systolic dysfunction of left ventricle. Ann Noninvasive Electrocardiol 13:155–164PubMedCrossRefGoogle Scholar
  28. Galimberti CA, Marchioni E, Barzizza F, Manni R, Sartori I et al (1996) Partial epileptic seizures of different origin variably affect cardiac rhythm. Epilepsia 37:742–747PubMedCrossRefGoogle Scholar
  29. Garcia M, D’Giano C, Estelles S, Leiguarda R, Rabinowicz A (2001) Ictal tachycardia: its discriminating potential between temporal and extratemporal seizure foci. Seizure 10:415–419PubMedCrossRefGoogle Scholar
  30. Ghosh D, Dutta S, Chakraborty S, Samanta S (2017) Epileptic seizure: a new approach for quantification of autonomic deregulation with Chaos based technique. Transl Biomed 8:106CrossRefGoogle Scholar
  31. Goldberger AL (1996) Non-linear dynamics for clinicians: chaos theory, fractals, and complexity at the bedside. Lancet 11:1312–1314CrossRefGoogle Scholar
  32. Goldberger AL, Amaral LAN, Haussdorff JM, Ivanov PC, Peng CK et al (2002) Fractal dynamics in physiology: alterations with disease and aging. Proc Natl Acad Sci USA 99:2466–2472PubMedCrossRefGoogle Scholar
  33. Hennessy MJ, Tighe MG, Binnie CD, Nashef L (2001) Sudden withdrawal of carbamazepine increases cardiac sympathetic activity in sleep. Neurology 57:1650–1654PubMedCrossRefPubMedCentralGoogle Scholar
  34. Hilz MJ, Devinsky O, Doyle W, Mauerer A, Dutsch M (2002) Decrease of sympathetic cardiovascular modulation after temporal lobe epilepsy surgery. Brain 125:985–995PubMedCrossRefPubMedCentralGoogle Scholar
  35. Ho KKL, Moody GB, Peng CK, Mietus JE, Larson MG et al (1997) Predicting survival in heart failure cases and controls using fully automated methods for deriving non-linear and conventional indices of heart rate dynamics. Circulation 96:842–848PubMedCrossRefPubMedCentralGoogle Scholar
  36. Huikuri HV, Seppänen T, Koistinen MJ, Airaksinen KEJ, Ikäheimo MJ et al (1996) Abnormalities in beat-to-beat dynamics of heart rate before the spontaneous onset of life-threatening ventricular tachyarrhythmias in patients with prior myocardial infarction. Circulation 93:1836–1844PubMedCrossRefPubMedCentralGoogle Scholar
  37. Ihlen EAF (2012) Introduction to multifractal detrended fluctuation analysis in Matlab. Front Physiol 3:141PubMedPubMedCentralCrossRefGoogle Scholar
  38. Isojarvi JIT, Ansakorpi H, Suominen K, Tolonen U, Repo M, Myllyla VV (1998) Interictal cardiovascular autonomic responses in patients with epilepsy. Epilepsia 39:420–426PubMedCrossRefGoogle Scholar
  39. Ivanov PC, Amaral LAN, Goldberger AL, Havlin S, Rosenblum MG et al (1999) Multifractality in human heartbeat dynamics. Nature 399:461–465PubMedPubMedCentralCrossRefGoogle Scholar
  40. Ivanov PC, Chen Z, Hu K, Stanley HE (2004) Multiscale aspects of cardiac control. Physica A 344:685–704CrossRefGoogle Scholar
  41. Ives JR, Mainwaring NR, Krishnamurthy KB, Blum AS, Drislane FW et al (1996) Technical implementation and clinical findings/results of monitoring oxygen saturation in patients referred for long-term EEG monitoring. Electroencephalogr Clin Neurophysiol 99:432–439PubMedCrossRefGoogle Scholar
  42. Janszky J, Fogarasi A, Toth V, Magalova V, Gyimesi C et al (2007) Peri-ictal vegetative symptoms in temporal lobe epilepsy. Epilepsy Behav 11:125–129PubMedCrossRefGoogle Scholar
  43. Jensen K, Lagae L (2010) Cardiac changes in epilepsy. Seizure 19:455–460CrossRefGoogle Scholar
  44. Jansen K, Varon C, Huffel SV, Lagae L (2013) Peri-ictal ECG changes in childhood epilepsy: implications for detection systems. Epilepsy Behav 29:72–76PubMedCrossRefGoogle Scholar
  45. Jovic A, Bogunovic N (2010) Classification of biological signals based on non-linear features. In: Melecon 2010–2010 15th IEEE Mediterranean electrotechnical conferenceGoogle Scholar
  46. Kamal A (2006) Assessment of autonomic function for healthy and diabetic patientsUsing entrainment methods and spectral techniques. In: IEEE 32nd annual northeast bioengineering conference, Easton, Pennsylvania, April 1–2, pp 161–162Google Scholar
  47. Kamal AK (2010) Assessment of autonomic function in epileptic patients. Neurosciences (Riyadh) 15:244–248Google Scholar
  48. Kamal AK (2014) Novel method for assessment of autonomic function in health and disease: an application to epilepsy. Int J Neurorehabil 1:133CrossRefGoogle Scholar
  49. Kantelhardt JW, Zschiegner SA, Bunde EK, Bunde A, Havlin S et al (2002) Multifractal detrended fluctuation of nonstationary time series. Physica A 316:87–114CrossRefGoogle Scholar
  50. Kantelhardt JW, Rybski D, Zschiegner SA, Braun P, Bunde EK et al (2003) Multifractality of river runoff and precipitation: comparison of fluctuation analysis and wavelet methods. Physica A 330:240–245CrossRefGoogle Scholar
  51. Keilson MJ, Hauser WA, Magrill JP (1989) Electrocardiographic changes during electrographic seizures. Arch Neurol 46:1169–1170PubMedCrossRefGoogle Scholar
  52. Kolsal E, Serdaroğlu A, Çilsal E, Kula S, Soysal AS et al (2014) Can heart rate variability in children with epilepsy be used to predict seizures? Seizure 23:357–362PubMedCrossRefGoogle Scholar
  53. Lahrmann H, Cortelli P, Hilz M, Mathias CJ, Struhal W et al (2006) EFNS guidelines on the diagnosis and management of orthostatic hypotension. Eur J Neurol 13:930–936PubMedCrossRefGoogle Scholar
  54. Langan Y, Nashef L, Sander JWAS (2000) Sudden unexpected death in epilepsy: a series of witnessed deaths. J Neurol Neurosurg Psychiatry 68:211–213PubMedPubMedCentralCrossRefGoogle Scholar
  55. Lass J (2002) Biosignal interpretation: study of cardiac arrhythmias and electromagnetic field effects on human nervous system (PhD thesis). TTU Press, TallinGoogle Scholar
  56. Leutmezer F, Schernthaner C, Lurger S, Pötzelberger K, Baumgartner C (2003) Electrocardiographic changes at the onset of epileptic seizures. Epilepsia 44:348–354PubMedCrossRefGoogle Scholar
  57. Lin DC, Hughson RL (2001) Modeling heart rate variability in healthy humans: a turbulence analogy. Phys Rev Lett 86:1650–1653PubMedCrossRefGoogle Scholar
  58. Mäkikallio TH, Seppänen T, Niemelä M, Airaksinen KE, Tulppo M et al (1996) Abnormalities in beat to beat complexity of heart rate dynamics in patients with a previous myocardial infarction. J Am Coll Cardiol 28:1005–1011PubMedCrossRefGoogle Scholar
  59. Mäkikallio TH, Seppänen T, Airaksinen KEJ, Koistinen J, Tulppo MP et al (1997) Dynamic analysis of heart rate may predict subsequent ventricular tachycardia after myocardial infarction. Am J Cardiol 80:779–783PubMedCrossRefGoogle Scholar
  60. Makowiec D, Galaska R, Dudkowska A, Rynkiewicz A, Zwierz M (2006) Long-range dependencies in heart rate signals-revisited. Physica A 369:632–644CrossRefGoogle Scholar
  61. Makowiec D, Dudkowska A, Galaska R, Rynkiewicz A (2007) Multifractal analysis of normal RR heart-interbeat signals in power spectra ranges. arXiv:q-bio/0702047v1Google Scholar
  62. Marshall DW, Westmoreland BF, Sharbrough FW (1983) Ictal tachycardia during temporal lobe seizures. Mayo Clin Proc 58:443–446PubMedGoogle Scholar
  63. Massetani R, Strata G, Galli R, Gori S, Gneri C et al (1997) Alteration of cardiac function in patients with temporal lobe epilepsy: different roles of EEG/ECG monitoring and spectral analysis of RR variability. Epilepsia 38:363–369PubMedCrossRefGoogle Scholar
  64. Meregnani J, Clarençon D, Vivier M, Peinnequin A, Mouret C et al (2011) Anti-inflammatory effect of vagus nerve stimulation in a rat model of inflammatory bowel disease. Auton Neurosci 160:82–89PubMedCrossRefGoogle Scholar
  65. Mayer H, Benninger F, Urak L, Plattner B, Geldner J, Feucht M (2004) EKG abnormalities in children and adolescents with symptomatic temporal lobe epilepsy. Neurology 63:324–328PubMedCrossRefGoogle Scholar
  66. Meyer M, Marconi C, Ferretti G, Fiocchi R, Skinner JE et al (1998a) Is the heart preadapted to hypoxia? Evidence from fractal dynamics of heartbeat interval fluctuations at high altitude (5050 m). Integr Psychol Behav Sci 33:9–40CrossRefGoogle Scholar
  67. Meyer M, Rahmel A, Marconi C, Grassi B, Cerretelli P et al (1998b) Stability of heartbeat interval distributions in chronic high altitude hypoxia. Integr Psychol Behav Sci 33:344–362CrossRefGoogle Scholar
  68. Meyer M (2002) Fractal scaling of heart rate dynamics in health and disease. Fractals in biology and medicine, vol 3, Birkhäuser, Basel, pp 181–193Google Scholar
  69. Meyer M, Stiedl O, Kerman B (2003) Discrimination by multifractal spectrum estimation of human heartbeat interval dynamics. Fractals 11:195–204CrossRefGoogle Scholar
  70. Meyer M, Stiedl O (2003) Self-affine fractal variability of human heartbeat interval dynamics in health and disease. Eur J Appl Physiol 90:305–316PubMedCrossRefGoogle Scholar
  71. Montano N, Porta A, Cogliati C, Constantino G, Tobaldini E et al (2008) Heart rate variability explored in the frequency domain: a tool to investigate the link between heart and behavior. Neurosci Biobehav Rev 33:71–80PubMedCrossRefGoogle Scholar
  72. Moseley BD, Wirrell EC, Nickels K, Johnson JN, Ackerman MJ, Britton J (2011) Electrocardiographic and oximetric changes during partial complex and generalized seizures. Epilepsy Res 95:237–245PubMedCrossRefGoogle Scholar
  73. Moseley B, Bateman L, Millichap JJ, Wirrell E, Panayiotopoulos CP (2013) Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP. Epilepsy Behav 26:375–385PubMedCrossRefGoogle Scholar
  74. Naritoku DK, Casebeer DJ, Darbin O (2003) Effects of seizure repetition on postictal and interictal neurocardiac regulation in the rat. Epilepsia 44:912–916PubMedCrossRefGoogle Scholar
  75. Nashef L, Walker F, Allen P, Sander JW, Shorvon SD, Fish DR (1996) Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry 60:297–300PubMedPubMedCentralCrossRefGoogle Scholar
  76. Nei M, Fertala K, Mintzer S, Skidmore C, Zangaladze A et al (2007) Heart rate and blood pressure in sudden unexpected death in epilepsy. Presented at the annual meeting of the American Academy of Neurology. Boston, MA, May, 2007Google Scholar
  77. Nei M (2009) Cardiac effects of seizures. Epilepsy Curr 9:91–95PubMedPubMedCentralCrossRefGoogle Scholar
  78. Nilsen KB, Haram M, Tangedal S, Sand T, Brodtkorb E (2010) Is elevated pre-ictal heart rate associated with secondary generalization in partial epilepsy? Seizure 19:291–295PubMedCrossRefGoogle Scholar
  79. Novak P (2011) Quantitative autonomic testing. J Vis Exp 53:2502Google Scholar
  80. Oppenheimer S (2001) Forebrain lateralization and the cardiovascular correlates of epilepsy. Brain 124:2345–2346PubMedCrossRefGoogle Scholar
  81. Peng CK, Mietus J, Hausdorff JM, Havlin S, Stanley HE et al (1993) Long-range anticorrelations and non-Gaussian behavior of the heartbeat. Phys Rev Lett 70:1343–1346CrossRefGoogle Scholar
  82. Peng CK, Havlin S, Stanley HE, Goldberger AL (1995) Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 5:82–87PubMedCrossRefGoogle Scholar
  83. Persson H, Kumlien E, Ericson M, Tomson T (2005) Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy. Neurology 65:1021–1025PubMedCrossRefGoogle Scholar
  84. Pomfrett CJ (1999) Heart rate variability, BIS and depth of anaesthesia. Br J Anaesth 82:559–661CrossRefGoogle Scholar
  85. Previnaire JG, Soler JM, Leclercq V, Denys P (2012) Severity of autonomic dysfunction in patients with complete spinal cord injury. Clin Auton Res 22:9–15PubMedCrossRefGoogle Scholar
  86. Qarage M, Ismail M, Serpedin E, Zulfi H (2016) Epileptic seizure onset detection based on EEG and ECG data fusion. Epilepsy Behav 58:48–60CrossRefGoogle Scholar
  87. Rocamora R, Kurthen M, Lickfett L, Von Oertzen J, Elger CE (2003) Cardiac asystole in epilepsy: clinical and neurophysiologic features. Epilepsia 44:179–185PubMedCrossRefGoogle Scholar
  88. Ronkainen E, Ansakorpi H, Huikuri HV, Myllyla VV, Isojarvi JI, Korpelainen JT (2005) Suppressed circadian heart rate dynamics in temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 76:1382–1386PubMedPubMedCentralCrossRefGoogle Scholar
  89. Rowan WH 3rd, Campen MJ, Wichers LB, Watkinson WP (2007) Heart rate variability in rodents: uses and caveats in toxicological studies. Cardiovasc Toxicol 7:28–51PubMedCrossRefGoogle Scholar
  90. Sahin D, Ilbay G, Imal M, Bozdogan O, Ates N (2009) Vagus nerve stimulation suppresses generalized seizure activity and seizuretriggered postictal cardiac rhythm changes in rats. Physiol Res 58:345–350PubMedGoogle Scholar
  91. Sathyaprabha TN, Satishchandra P, Netravathi K, Sinha S, Thennarasu K, Raju TR (2006) Cardiac autonomic dysfunctions in chronic refractory epilepsy. Epilepsy Res 72:49–56PubMedCrossRefGoogle Scholar
  92. Schernthaner C, Lindinger G, Potzelberger K, Zeiler K, Baumgartner C (1999) Autonomic epilepsy–the influence of epileptic discharges on heart rate and rhythm. Wien Klin Wochenschr 111:392–401PubMedGoogle Scholar
  93. Sleight JW, Donovan J (1999) Comparison of bispectral index, 95% spectral edge frequency and approximate entropy of the EEG, with changes in heart rate variability during induction of general anaesthesia. Br J Anaesth 82:666–671CrossRefGoogle Scholar
  94. Smith PEM, Howell SJ, Owen L, Blumhardt LD (1989) Profiles of instant heart rate during partial seizures. Electroencephalogr Clin Neurophysiol 72:207–217PubMedCrossRefGoogle Scholar
  95. Stiedl O, Jansen RF, Pieneman AW, Ögren SO, Meyer M (2009) Assessing aversive emotional states through the heart in mice: implications for cardiovascular dysregulation in affective disorders. Neurosci Biobehav Rev 33:181–190PubMedCrossRefGoogle Scholar
  96. Stiedl O, Meyer M (2003) Fractal dynamics in circadian time series of cortico-tropin-releasing factor subtype 2-deficient mice. J Math Biol 47:169–197PubMedCrossRefGoogle Scholar
  97. Stiedl O, Tovote P, Ögren SO, Meyer M (2004) Behavioral and autonomic dynamics during contextual fear conditioning in mice. Auton Neurosci 115:15–27PubMedCrossRefGoogle Scholar
  98. Su ZY, Wu T, Yang PH, Wang YT (2008) Dynamic analysis of heartbeat rate signals of epileptics using multidimensional phase space reconstruction approach. Physica A 387:2293–2305CrossRefGoogle Scholar
  99. Surges R (2010) Enhanced QT shortening and persistent tachycardia after generalized seizures. Neurology 74:421–426PubMedPubMedCentralCrossRefGoogle Scholar
  100. Thurner S, Feurstein MC, Teich MC (1998) Multiresolution wavelet analysis of heartbeat intervals discriminates healthy patients from those with cardiac pathology. Phys Rev Lett 80:1544–1547CrossRefGoogle Scholar
  101. Tinuper P, Bisulli F, Cerullo A, Carcangiu R, Marini C et al (2001) Ictal bradycardia in partial epileptic seizures: autonomic investigation in three cases and literature review. Brain 124:2361–2371PubMedCrossRefGoogle Scholar
  102. Vanage AM, Khade RH, Shinde DB (2012) Classifying five different arrhythmias by analyzing the ECG signals. IJCEM 15:2230–7893Google Scholar
  103. Van der Kruijs SJM, Vonck KEJ, Feijs LMG, Bodde NMG, Lazeron RHC et al (2014) Autonomic nervous system functioning associated with epileptic seizures: analysis of heart rate variability. J Neurol Neurophysiol 5:215–217Google Scholar
  104. Van der Lende M, Surges R, Sander JW, Thijs RD (2015) Cardiac arrhythmias during or after epileptic seizures. J Neurol Neurosurg Psychiatry 10:1–6Google Scholar
  105. Varon C, Jansen K, Lagae L, Huffel SV (2013) Detection of epileptic seizures by means of morphological changes in the ECG. In: Computing in cardiology conference, pp 8630–8866Google Scholar
  106. Varon C, Jansen K, Lagae L, Huffel SV (2015) Can ECG monitoring identify seizures? J Electrocardiol 48:1069–1074PubMedCrossRefGoogle Scholar
  107. Wang J, Ning X, Chen Y (2003) Multifractal analysis of electronic cardiogram taken from healthy and unhealthy adult subjects. Physica A 323:561–568CrossRefGoogle Scholar
  108. Widdess-Walsh P, Kotagal P, Jeha L, Wu G, Burgess R (2007) Multiple auras: clinical significance and pathophysiology. Neurology 69:755–761PubMedCrossRefGoogle Scholar
  109. Wong SH, Adams P, Jackson M (2008) The electrocardiograph (ECG) in a first seizure clinic. Seizure 17:707–710PubMedCrossRefGoogle Scholar
  110. Woo MA, Stevenson WG, Moser DK, Middlekauff HR (1994) Complex heart rate variability and serum norepinephrine levels in patients with advanced heart failure. J Am Coll Cardiol 23:565–569PubMedCrossRefGoogle Scholar
  111. Yoshikawa Y, Yasuda Y (2003) Non-linear dynamics in heart rate variability in different generations. Bull Toyohashi Sozo Coll 7:63–78Google Scholar
  112. Zamponi N, Passamonti C, Cesaroni E, Trignani R, Rychlicki F (2011) Effectiveness of vagal nerve stimulation (VNS) in patients with drop-attacks and different epileptic syndromes. Seizure 20:468–474PubMedCrossRefGoogle Scholar
  113. Zijlmans M, Flanagan D, Gotman J (2002) Heart rate changes and ECG abnormalities during epileptic seizures: prevalence and definition of an objective clinical sign. Epilepsia 43:847–854PubMedCrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of PhysicsSir C V Raman Centre for Physics and Music, Jadavpur UniversityKolkataIndia
  2. 2.Department for PhysicsSeacom Engineering CollegeHowrahIndia
  3. 3.Electrical and Electronics EngineeringICFAI UniversityAgartalaIndia

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