A pediatric epilepsy diagnostic tool for use in resource-limited settings: A pilot study

Area of Science:

• Neurology
• Global Health
• Medical Diagnostics

Background:

• Epilepsy affects 50 million globally, with 80% in resource-limited areas lacking specialist care.
• Primary healthcare providers often manage epilepsy with limited training and diagnostic tools.

Purpose of the Study:

• To develop and pilot a questionnaire to differentiate focal from generalized epilepsy in children.
• To improve diagnostic accuracy for guiding epilepsy medication choices in resource-limited settings.

Main Methods:

• A 15-item questionnaire was developed from literature and chart reviews, excluding simple motor seizures.
• The questionnaire was translated and prospectively validated in Tanzania and Zambia with 59 children (6 months-18 years).
• Caregiver responses were compared against a gold standard diagnosis by a pediatric neurologist, including EEG interpretation.

Main Results:

• Of 43 eligible patients, 65% had focal epilepsy and 35% had generalized epilepsy.
• The questionnaire demonstrated a sensitivity of 78% and a positive predictive value of 81.5%.
• Statistical analysis confirmed the questionnaire's discriminative validity in classifying epilepsy types (p<0.001).

Conclusions:

• The developed questionnaire offers a simple method to enhance diagnostic accuracy for pediatric epilepsy in resource-limited settings.
• This tool can assist healthcare providers in bridging the diagnostic gap and potentially guiding treatment decisions.
• Further validation in diverse settings is recommended to assess its impact on clinical practice and patient outcomes.