TY - JOUR
T1 - Electroencephalographic features of convulsive epilepsy in Africa
T2 - A multicentre study of prevalence, pattern and associated factors
AU - on behalf of SEEDS investigators
AU - Kariuki, Symon M.
AU - White, Steven
AU - Chengo, Eddie
AU - Wagner, Ryan G.
AU - Ae-Ngibise, Kenneth A.
AU - Kakooza-Mwesige, Angelina
AU - Ngugi, Anthony K.
AU - Sander, Josemir W.
AU - Neville, Brian G.
AU - Newton, Charles R.
AU - Twine, Rhian
AU - Connor, Myles
AU - Olivé, F. Xavier Gómez
AU - Collinson, Mark
AU - Kahn, Kathleen
AU - Tollman, Stephen
AU - Masanja, Honratio
AU - Masanja, Honratio
AU - Kakooza, Angelina
AU - Pariyo, George
AU - Peterson, Stefan
AU - Ndyomughenyi, Donald
AU - Odhiambo, Rachael
AU - Chabi, Martin
AU - Bauni, Evasius
AU - Kamuyu, Gathoni
AU - Odera, Victor Mung ala
AU - Mageto, James O.
AU - Ae-Ngibise, Ken
AU - Akpalu, Bright
AU - Akpalu, Albert
AU - Agbokey, Francis
AU - Adjei, Patrick
AU - Owusu-Agyei, Seth
AU - Bottomley, Christian
AU - Kleinschmidt, Immo
AU - Doku, Victor C.K.
AU - Odermatt, Peter
AU - Neville, Brian
AU - Nutman, Thomas
AU - Wilkins, Patricia
AU - Noh, John
N1 - Funding Information:
This study was supported by the Wellcome Trust , through a Senior Research Fellowship ( 083744 ) to C.R.N. S.K. is supported by the Wellcome Trust ( 099782/Z/12/Z ). J.W.S. is supported by the Dr. Marvin Weil Epilepsy Research Fund and is based at UCLH/UCL, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme. The sponsors had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. We are grateful to Doctor Gail Bell for appraising the manuscript. This paper is published with permission of the director of KEMRI.
Publisher Copyright:
© 2015 International Federation of Clinical Neurophysiology.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: We investigated the prevalence and pattern of electroencephalographic (EEG) features of epilepsy and the associated factors in Africans with active convulsive epilepsy (ACE). Methods: We characterized electroencephalographic features and determined associated factors in a sample of people with ACE in five African sites. Mixed-effects modified Poisson regression model was used to determine factors associated with abnormal EEGs. Results: Recordings were performed on 1426 people of whom 751 (53%) had abnormal EEGs, being an adjusted prevalence of 2.7 (95% confidence interval (95% CI), 2.5-2.9) per 1000. 52% of the abnormal EEG had focal features (75% with temporal lobe involvement). The frequency and pattern of changes differed with site. Abnormal EEGs were associated with adverse perinatal events (risk ratio (RR) = 1.19 (95% CI, 1.07-1.33)), cognitive impairments (RR = 1.50 (95% CI, 1.30-1.73)), use of anti-epileptic drugs (RR = 1.25 (95% CI, 1.05-1.49)), focal seizures (RR = 1.09 (95% CI, 1.00-1.19)) and seizure frequency (RR = 1.18 (95% CI, 1.10-1.26) for daily seizures; RR = 1.22 (95% CI, 1.10-1.35) for weekly seizures and RR = 1.15 (95% CI, 1.03-1.28) for monthly seizures)). Conclusions: EEG abnormalities are common in Africans with epilepsy and are associated with preventable risk factors. Significance: EEG is helpful in identifying focal epilepsy in Africa, where timing of focal aetiologies is problematic and there is a lack of neuroimaging services.
AB - Objective: We investigated the prevalence and pattern of electroencephalographic (EEG) features of epilepsy and the associated factors in Africans with active convulsive epilepsy (ACE). Methods: We characterized electroencephalographic features and determined associated factors in a sample of people with ACE in five African sites. Mixed-effects modified Poisson regression model was used to determine factors associated with abnormal EEGs. Results: Recordings were performed on 1426 people of whom 751 (53%) had abnormal EEGs, being an adjusted prevalence of 2.7 (95% confidence interval (95% CI), 2.5-2.9) per 1000. 52% of the abnormal EEG had focal features (75% with temporal lobe involvement). The frequency and pattern of changes differed with site. Abnormal EEGs were associated with adverse perinatal events (risk ratio (RR) = 1.19 (95% CI, 1.07-1.33)), cognitive impairments (RR = 1.50 (95% CI, 1.30-1.73)), use of anti-epileptic drugs (RR = 1.25 (95% CI, 1.05-1.49)), focal seizures (RR = 1.09 (95% CI, 1.00-1.19)) and seizure frequency (RR = 1.18 (95% CI, 1.10-1.26) for daily seizures; RR = 1.22 (95% CI, 1.10-1.35) for weekly seizures and RR = 1.15 (95% CI, 1.03-1.28) for monthly seizures)). Conclusions: EEG abnormalities are common in Africans with epilepsy and are associated with preventable risk factors. Significance: EEG is helpful in identifying focal epilepsy in Africa, where timing of focal aetiologies is problematic and there is a lack of neuroimaging services.
KW - Active convulsive epilepsy
KW - Africa
KW - Electroencephalographic features
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=84957941221&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2015.07.033
DO - 10.1016/j.clinph.2015.07.033
M3 - Article
C2 - 26337840
AN - SCOPUS:84957941221
SN - 1388-2457
VL - 127
SP - 1099
EP - 1107
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 2
ER -