Tablet-based electroencephalography diagnostics for patients with epilepsy in the West African Republic of Guinea.

Adolescent Electroencephalography Epilepsy / diagnosis Female Guinea Humans Male Reproducibility of Results Seizures / diagnosis
Africa diagnosis electroencephalography epilepsy seizure telemedicine

Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
08 2020
Historique:
received: 29 01 2020
accepted: 24 04 2020
pubmed: 3 5 2020
medline: 22 6 2021
entrez: 3 5 2020
Statut: ppublish

Résumé

Epilepsy 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. Tablet-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. There were 149 participants (41% female; median age 17.9 years; 66.6% ≤21 years of age; mean seizures per month 5.7 ± SD 15.5). The mean duration of EEG1 was 53 ± 12.3 min and that of EEG2 was 29.6 ± 12.8 min. 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. Tablet-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.

Sections du résumé

BACKGROUND AND PURPOSE
Epilepsy 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.
METHODS
Tablet-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.
RESULTS
There were 149 participants (41% female; median age 17.9 years; 66.6% ≤21 years of age; mean seizures per month 5.7 ± SD 15.5). The mean duration of EEG1 was 53 ± 12.3 min and that of EEG2 was 29.6 ± 12.8 min. 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.
CONCLUSIONS
Tablet-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.

Identifiants

DOI: 10.1111/ene.14291 PMID: 32359218 PMC: PMC8830803
pubmed: 32359218
doi: 10.1111/ene.14291
pmc: PMC8830803
mid: NIHMS1752064
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1570-1577

Subventions

Organisme : NINDS NIH HHS
ID : R21 NS098886
Pays : United States
Organisme : Hospital Corporation of America (HCA) International Foundation
Pays : International

Informations de copyright

© 2020 European Academy of Neurology.

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Auteurs

E Sokolov (E)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

D H Abdoul Bachir (DH)

Department of Neurology, Ignace Deen Hospital, Conakry, Guinea.

F Sakadi (F)

Department of Neurology, Ignace Deen Hospital, Conakry, Guinea.

J Williams (J)

Department of Neurology, Mater Misericordiae University Hospital and Dublin Neurological Institute, Dublin, Ireland.

A C Vogel (AC)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

M Schaekermann (M)

University of Waterloo, Waterloo, ON, Canada.

N Tassiou (N)

Department of Neurology, Ignace Deen Hospital, Conakry, Guinea.

A K Bah (AK)

Department of Neurology, Ignace Deen Hospital, Conakry, Guinea.

V Khatri (V)

Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

G C Hotan (GC)

Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, MA, USA.

N Ayub (N)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

E Leung (E)

Department of Pediatrics, University of Manitoba, Winnipeg, MB, USA.
Children's Hospital Research Institute of Manitoba, Winnipeg, MB, USA.

T A Fantaneanu (TA)

Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada.

A Patel (A)

Harvard Medical School, Boston, MA, USA.
Department of Neurology, Boston Children's Hospital, Boston, MA, USA.

M Vyas (M)

Division of Neurology, University of Toronto, Toronto, ON, USA.

T Milligan (T)

Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

M F Villamar (MF)

Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

D Hoch (D)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

S Purves (S)

University of British Columbia, Vancouver, BC, Canada.

B Esmaeili (B)

Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

M Stanley (M)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

T Lehn-Schioler (T)

Danish Technical University, Copenhagen, Denmark.

J Tellez-Zenteno (J)

University of Saskatchewan College of Medicine, Saskatoon, SK, Canada.

E Gonzalez-Giraldo (E)

University of California, San Francisco, CA, USA.

I Tolokh (I)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.

L Heidarian (L)

University of Utah, Salt Lake City, UT, USA.

L Worden (L)

Children's Hospital of Philadelphia, PA, USA.
ORCID: 0000-0003-2268-0206

N Jadeja (N)

University of Massachusetts School of Medicine, Boston, MA, USA.

S Fridinger (S)

Children's Hospital of Philadelphia, PA, USA.

L Lee (L)

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

E Law (E)

University of Waterloo, Waterloo, ON, Canada.

C Fodé Abass (C)

Department of Neurology, Ignace Deen Hospital, Conakry, Guinea.

F J Mateen (FJ)

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
ORCID: 0000-0002-4293-8115

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Tablet-based electroencephalography...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électroencéphalographie › Tablet-based electroencephalography...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Encéphalopathies › Épilepsie › Tablet-based electroencephalography...
questionsmedicales.fr › Régions géographiques › Afrique › Afrique subsaharienne › Afrique de l'Ouest › Guinée › Tablet-based electroencephalography...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Tablet-based electroencephalography...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Reproductibilité des résultats › Tablet-based electroencephalography...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Crises épileptiques › Tablet-based electroencephalography...