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Sokolov E, Abdoul Bachir DH, Sakadi F, Williams J, Vogel AC, Schaekermann M, Tassiou N, Bah AK, Khatri V, Hotan GC, Ayub N, Leung E, Fantaneanu TA, Patel A, Vyas M, Milligan T, Villamar MF, Hoch D, Purves S, Esmaeili B, Stanley M, Lehn-Schioler T, Tellez-Zenteno J, Gonzalez-Giraldo E, Tolokh I, Heidarian L, Worden L, Jadeja N, Fridinger S, Lee L, Law E, Fodé Abass C, Mateen FJ. Tablet-based electroencephalography diagnostics for patients with epilepsy in the West African Republic of Guinea. Eur J Neurol 2020; 27:1570-1577. [PMID: 32359218 DOI: 10.1111/ene.14291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/24/2020] [Indexed: 02/02/2023]
Abstract
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.
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Affiliation(s)
- E Sokolov
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - F Sakadi
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - J Williams
- Department of Neurology, Mater Misericordiae University Hospital and Dublin Neurological Institute, Dublin, Ireland
| | - A C Vogel
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - N Tassiou
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - A K Bah
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - V Khatri
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - G C Hotan
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, MA, USA
| | - N Ayub
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - E Leung
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, USA.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, USA
| | - T A Fantaneanu
- Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada
| | - A Patel
- Harvard Medical School, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - M Vyas
- Division of Neurology, University of Toronto, Toronto, ON, USA
| | - T Milligan
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - M F Villamar
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - D Hoch
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - S Purves
- University of British Columbia, Vancouver, BC, Canada
| | - B Esmaeili
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - M Stanley
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | | - J Tellez-Zenteno
- University of Saskatchewan College of Medicine, Saskatoon, SK, Canada
| | | | - I Tolokh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | | - L Worden
- Children's Hospital of Philadelphia, PA, USA
| | - N Jadeja
- University of Massachusetts School of Medicine, Boston, MA, USA
| | - S Fridinger
- Children's Hospital of Philadelphia, PA, USA
| | - L Lee
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - E Law
- University of Waterloo, Waterloo, ON, Canada
| | - C Fodé Abass
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - F J Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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