1. Tablet‐based electroencephalography diagnostics for patients with epilepsy in the West African Republic of Guinea
- Author
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J Williams, Tadeu A. Fantaneanu, D H Abdoul Bachir, Sara E. Fridinger, Lila T. Worden, Neishay Ayub, Andre C. Vogel, Farrah J. Mateen, S. J. Purves, Behnaz Esmaeili, Elisaveta Sokolov, F. Sakadi, V Khatri, Michael Stanley, Ernesto Gonzalez-Giraldo, Neville Jadeja, Illya Tolokh, Nana Rahamatou Tassiou, L Heidarian, Edith Law, Manav V. Vyas, Archana Patel, Gladia C. Hotan, Tue Lehn-Schiøler, Daniel B. Hoch, Tracey A. Milligan, Liesly Lee, Edward Leung, Mauricio F. Villamar, Aissatou Kenda Bah, Mike Schaekermann, C Fodé Abass, and Jose F. Tellez-Zenteno
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,diagnosis ,seizure ,Clinical Sciences ,Variable time ,Neurodegenerative ,Electroencephalography ,Clinical neurophysiology ,Article ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Seizures ,Clinical Research ,Humans ,Medicine ,030212 general & internal medicine ,Neurology & Neurosurgery ,medicine.diagnostic_test ,business.industry ,Neurosciences ,Reproducibility of Results ,medicine.disease ,Brain Disorders ,West african ,Good Health and Well Being ,Neurology ,Africa ,EEG device ,Cohort ,Guinea ,Female ,telemedicine ,Neurology (clinical) ,Quality level ,business ,030217 neurology & neurosurgery - Abstract
Background and purposeEpilepsy is most common in lower-income settings where access to electroencephalography (EEG) is generally poor. A low-cost tablet-based EEG device may be valuable, but the quality and reproducibility of the EEG output are not established.MethodsTablet-based EEG was deployed in a heterogeneous epilepsy cohort in the Republic of Guinea (2018-2019), consisting of a tablet wirelessly connected to a 14-electrode cap. Participants underwent EEG twice (EEG1 and EEG2), separated by a variable time interval. Recordings were scored remotely by experts in clinical neurophysiology as to data quality and clinical utility.ResultsThere were 149 participants (41% female; median age 17.9years; 66.6% ≤21years of age; mean seizures per month 5.7±SD 15.5). The mean duration of EEG1 was 53±12.3min and that of EEG2 was 29.6±12.8min. The mean quality scores of EEG1 and EEG2 were 6.4 [range, 1 (low) to 10 (high); both medians 7.0]. A total of 44 (29.5%) participants had epileptiform discharges (EDs) at EEG1 and 25 (16.8%) had EDs at EEG2. EDs were focal/multifocal (rather than generalized) in 70.1% of EEG1 and 72.5% of EEG2 interpretations. A total of 39 (26.2%) were recommended for neuroimaging after EEG1 and 22 (14.8%) after EEG2. Of participants without EDs at EEG1 (n=53, 55.8%), seven (13.2%) had EDs at EEG2. Of participants with detectable EDs on EEG1 (n=23, 24.2%), 12 (52.1%) did not have EDs at EEG2.ConclusionsTablet-based EEG had a reproducible quality level on repeat testing and was useful for the detection of EDs. The incremental yield of a second EEG in this setting was ~13%. The need for neuroimaging access was evident.
- Published
- 2020
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