Remote diagnosis of pediatric epilepsy through a smartphone-based EEG
The
majority of children with epilepsy (CWE) live in low- and middle-income
countries (LMICs).Electroencephalography (EEG) aids the diagnosis and characterization of
epilepsy in higher income settings, but can be especially difficult to access
among CWE in resource-limited locations and LMICs.Smartphones, owned by more than 2.6 billion
people, now offer a potential solution for the distribution of EEG to
populations globally.In this study in
the lower-income, Himalayan Kingdom of Bhutan, we will test and implement a
multi-platform, open-source, software application that combines off-the-shelf
EEG caps with a smartphone to acquire EEG in children with seizures and
epilepsy.This represents a low-cost,
real-time, fully portable EEG imaging system that obviates the need for paper
tracings, EEG technicians, and consistent electrical supplies. The smartphone
based EEG will be clinically tested in 150 children with poorly controlled
epilepsy — operationally defined as children who have experienced at least two
unprovoked seizures in the past year while taking at least one anti-epileptic
drug. The stated aim of this prospective interaction study, involving children
from newborns to 18 years old is the estimation of the number of children with
poorly controlled epilepsy who will receive improved characterization of their
epilepsy syndrome on a smartphone based EEG. This includes a team led by
applicant at the Jigme Dorji Wangchuck National Referral Hospital in Bhutan in
collaboration with the Institute for Traditional Medicines in Bhutan and
colleagues at the Massachusetts General Hospital’s Department of
Neurology.Accomplishment of the above
aims will provide the necessary data to randomize smartphone based versus usual
epilepsy care for children in several lower income countries through the scale
up of this model alongside complementary “disruptive”
smartphone-based health technologies for pediatric epilepsy care in the longer
term.