Cargando…
Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting
INTRODUCTION: Electroencephalography (EEG) remains the most important investigative modality in the diagnostic evaluation of individuals with epilepsy. Children living with epilepsy in the developing world are faced with challenges of lack of access to appropriate diagnostic evaluation and a high ri...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769815/ https://www.ncbi.nlm.nih.gov/pubmed/26977236 http://dx.doi.org/10.11604/pamj.2015.22.328.7065 |
_version_ | 1782418160939433984 |
---|---|
author | Lagunju, Ike Oluwa Abiola Oyinlade, Alexander Opebiyi Atalabi, Omolola Mojisola Ogbole, Godwin Tedimola, Olushola Famosaya, Abimbola Ogunniyi, Adesola Ogunseyinde, Ayotunde Oluremi Ragin, Ann |
author_facet | Lagunju, Ike Oluwa Abiola Oyinlade, Alexander Opebiyi Atalabi, Omolola Mojisola Ogbole, Godwin Tedimola, Olushola Famosaya, Abimbola Ogunniyi, Adesola Ogunseyinde, Ayotunde Oluremi Ragin, Ann |
author_sort | Lagunju, Ike Oluwa Abiola |
collection | PubMed |
description | INTRODUCTION: Electroencephalography (EEG) remains the most important investigative modality in the diagnostic evaluation of individuals with epilepsy. Children living with epilepsy in the developing world are faced with challenges of lack of access to appropriate diagnostic evaluation and a high risk of misdiagnosis and inappropriate therapy. We appraised EEG studies in a cohort of Nigerian children with epilepsy seen in a tertiary center in order to evaluate access to and the impact of EEG in the diagnostic evaluation of the cases. METHODS: Inter-ictal EEG was requested in all cases of pediatric epilepsy seen at the pediatric neurology clinic of the University College Hospital, Ibadan, Nigeria over a period of 18 months. Clinical diagnosis without EEG evaluation was compared with the final diagnosis post- EEG evaluation. RESULTS: A total of 329 EEGs were recorded in 329 children, aged 3months to 16 years, median 61.0 months. Clinical evaluation pre-EEG classified 69.3% of the epilepsies as generalized. The a posteriori EEG evaluations showed a considerably higher proportion of localization-related epilepsies (33.6%). The final evaluation post EEG showed a 21% reduction in the proportion of cases labeled as generalized epilepsy and a 55% increase in cases of localization-related epilepsy(p<0.001). CONCLUSION: Here we show that there is a high risk of misdiagnosis and therefore the use of inappropriate therapies in children with epilepsy in the absence of EEG evaluation. The implications of our findings in the resource-poor country scenario are key for reducing the burden of care and cost of epilepsy treatment on both the caregivers and the already overloaded tertiary care services. |
format | Online Article Text |
id | pubmed-4769815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-47698152016-03-14 Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting Lagunju, Ike Oluwa Abiola Oyinlade, Alexander Opebiyi Atalabi, Omolola Mojisola Ogbole, Godwin Tedimola, Olushola Famosaya, Abimbola Ogunniyi, Adesola Ogunseyinde, Ayotunde Oluremi Ragin, Ann Pan Afr Med J Research INTRODUCTION: Electroencephalography (EEG) remains the most important investigative modality in the diagnostic evaluation of individuals with epilepsy. Children living with epilepsy in the developing world are faced with challenges of lack of access to appropriate diagnostic evaluation and a high risk of misdiagnosis and inappropriate therapy. We appraised EEG studies in a cohort of Nigerian children with epilepsy seen in a tertiary center in order to evaluate access to and the impact of EEG in the diagnostic evaluation of the cases. METHODS: Inter-ictal EEG was requested in all cases of pediatric epilepsy seen at the pediatric neurology clinic of the University College Hospital, Ibadan, Nigeria over a period of 18 months. Clinical diagnosis without EEG evaluation was compared with the final diagnosis post- EEG evaluation. RESULTS: A total of 329 EEGs were recorded in 329 children, aged 3months to 16 years, median 61.0 months. Clinical evaluation pre-EEG classified 69.3% of the epilepsies as generalized. The a posteriori EEG evaluations showed a considerably higher proportion of localization-related epilepsies (33.6%). The final evaluation post EEG showed a 21% reduction in the proportion of cases labeled as generalized epilepsy and a 55% increase in cases of localization-related epilepsy(p<0.001). CONCLUSION: Here we show that there is a high risk of misdiagnosis and therefore the use of inappropriate therapies in children with epilepsy in the absence of EEG evaluation. The implications of our findings in the resource-poor country scenario are key for reducing the burden of care and cost of epilepsy treatment on both the caregivers and the already overloaded tertiary care services. The African Field Epidemiology Network 2015-12-03 /pmc/articles/PMC4769815/ /pubmed/26977236 http://dx.doi.org/10.11604/pamj.2015.22.328.7065 Text en © Ike Oluwa Abiola Lagunju et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Lagunju, Ike Oluwa Abiola Oyinlade, Alexander Opebiyi Atalabi, Omolola Mojisola Ogbole, Godwin Tedimola, Olushola Famosaya, Abimbola Ogunniyi, Adesola Ogunseyinde, Ayotunde Oluremi Ragin, Ann Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title | Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title_full | Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title_fullStr | Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title_full_unstemmed | Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title_short | Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
title_sort | electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769815/ https://www.ncbi.nlm.nih.gov/pubmed/26977236 http://dx.doi.org/10.11604/pamj.2015.22.328.7065 |
work_keys_str_mv | AT lagunjuikeoluwaabiola electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT oyinladealexanderopebiyi electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT atalabiomololamojisola electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT ogbolegodwin electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT tedimolaolushola electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT famosayaabimbola electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT ogunniyiadesola electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT ogunseyindeayotundeoluremi electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting AT raginann electroencephalographyasatoolforevidencebaseddiagnosisandimprovedoutcomesinchildrenwithepilepsyinaresourcepoorsetting |