Electroencephalogram Utilization, Epileptiform Findings, and Associated Factors Among Children with Epilepsy in
Fiona Okumu1, Moses Ochora2, Stuart Turanzomwe3
1Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.
Insights
Electroencephalography (EEG) is crucial for diagnosing childhood epilepsy in low-income countries. This study found epileptiform EEGs were more common in females and children with generalized seizures, highlighting a need for increased EEG use.
Area of Science:
- Neurology
- Pediatrics
- Medical Diagnostics
Background:
- Epilepsy is the most common neurological disorder in children in Low and Middle Income Countries (LMIC).
- Electroencephalography (EEG) is vital for epilepsy diagnosis and management, but its utilization is limited in LMICs.
- This study addresses the low uptake of EEG in children with epilepsy in South Western Uganda.
Purpose of the Study:
- To determine the proportion of children with epilepsy who underwent EEG.
- To identify the prevalence of epileptiform EEGs in this population.
- To investigate factors associated with epileptiform EEGs among children with epilepsy.
Main Methods:
- A retrospective record review of 427 children under 18 years old was conducted at Mbarara Regional Referral Hospital's Epilepsy Clinic.
- Data was collected using REDCAP and analyzed with STATA version 17.
- Modified Poisson regression was used to analyze factors associated with epileptiform EEGs.
Main Results:
- Only 34.9% of the 427 participants had undergone an EEG.
- Epileptiform EEG findings were present in 68.5% of children who had an EEG.
- Female sex (cPR: 1.98) and generalized seizures (cPR: 1.87) were independently associated with epileptiform EEGs.
Conclusions:
- Increased EEG utilization is recommended, particularly for children with generalized seizures.
- Training more healthcare workers in electro-encephalography is essential to improve epilepsy care in LMICs.
Objective:
Epilepsy is the most common neurological condition in children in Low and Middle Income Countries (LMIC). Although the diagnosis remains majorly clinical, EEG is fundamental in assessment and management of epilepsy. However, its uptake remains low in LMIC. We aimed to determine the proportion of children with epilepsy who have had an EEG, the proportion of epileptiform EEGs, and the factors associated with epileptiform EEGs among the children with epilepsy at a neurology clinic in South Western Uganda.
Methods:
We conducted a retrospective record review of 427 children less than 18 years old attending the Epilepsy Clinic at Mbarara Regional Referral Hospital. Records were selected by simple random sampling. A waiver of consent was obtained to study the medical records. Data was collected using REDCAP and analysed with STATA version 17. Proportions were reported as percentages and factors associated with epileptiform EEGs were analysed using the modified Poisson regression analysis.
Results:
Out of 427 participants in this study, 149 (34.9%) had done EEG. Epileptiform EEGs were observed among 102 (68.5%) children. The factors independently associated with epileptiform EEGs among the children with epilepsy included participants' sex and type of seizure. Having an epileptiform EEG was 1.98 times more likely among females than males (cPR:1.98, P -value 0.005) while it was 1.87 times more likely in children with generalized seizures compared to those with focal seizures (cPR:1.87, P-value=0.019).
Significance:
There is need for more EEGs to be done especially among children with generalized seizures. More health workers also need to be trained in electro-encephalography.
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