E Sokolov1, D H Abdoul Bachir2, F Sakadi2, J Williams3, A C Vogel1, M Schaekermann4, N Tassiou2, A K Bah2, V Khatri5,6, G C Hotan7, N Ayub1,6, E Leung8,9, T A Fantaneanu10, A Patel6,11, M Vyas12, T Milligan5,6, M F Villamar5,6, D Hoch1,6, S Purves13, B Esmaeili5,6, M Stanley1,6, T Lehn-Schioler14, J Tellez-Zenteno15, E Gonzalez-Giraldo16, I Tolokh1,6, L Heidarian17, L Worden18, N Jadeja19, S Fridinger18, L Lee20, E Law4, C Fodé Abass2, F J Mateen1,6. 1. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Neurology, Ignace Deen Hospital, Conakry, Guinea. 3. Department of Neurology, Mater Misericordiae University Hospital and Dublin Neurological Institute, Dublin, Ireland. 4. University of Waterloo, Waterloo, ON, Canada. 5. Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA. 6. Harvard Medical School, Boston, MA, USA. 7. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, MA, USA. 8. Department of Pediatrics, University of Manitoba, Winnipeg, MB, USA. 9. Children's Hospital Research Institute of Manitoba, Winnipeg, MB, USA. 10. Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada. 11. Department of Neurology, Boston Children's Hospital, Boston, MA, USA. 12. Division of Neurology, University of Toronto, Toronto, ON, USA. 13. University of British Columbia, Vancouver, BC, Canada. 14. Danish Technical University, Copenhagen, Denmark. 15. University of Saskatchewan College of Medicine, Saskatoon, SK, Canada. 16. University of California, San Francisco, CA, USA. 17. University of Utah, Salt Lake City, UT, USA. 18. Children's Hospital of Philadelphia, PA, USA. 19. University of Massachusetts School of Medicine, Boston, MA, USA. 20. Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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.
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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Authors: Jacob Bernstein; Samir Kashyap; Michael W Kortz; Bishoy Zakhary; Ariel Takayanagi; Harjyot Toor; Paras Savla; Margaret R Wacker; Ajay Ananda; Dan Miulli Journal: Surg Neurol Int Date: 2021-11-02
Authors: Andrea Biondi; Viviana Santoro; Pedro F Viana; Petroula Laiou; Deb K Pal; Elisa Bruno; Mark P Richardson Journal: Epilepsia Date: 2022-03-27 Impact factor: 6.740