Authors :
Presenting Author: Kaila Fives, – Lake Erie College of Osteopathic Medicine
Presenting Author: Douglas Nordli, – University of Chicago
Presenting Author: Douglas Nordli, – University of Chicago
Presenting Author: Douglas Nordli, – University of Chicago
Presenting Author: Douglas Nordli, – University of Chicago
Fernando Galan, MD – Nemours Childrens Health
Rationale:
Absence epilepsy comprises 13-20% of all epilepsy types in pediatrics. It remains one of the more favorable epilepsy types to treat. Its long-term prognosis and remission rates are superior to most other pediatric onset epilepsy syndromes. Despite these favorable features, quality of life can be impacted for children who experience absence seizures. School performance and associated self esteem are affected with uncontrolled seizures. Medications such as ethosuximide and valproic acid have shown efficacy in the treatment of absence seizures. Time to steady state for ethosuximide and valproic acid are between five to ten days. Despite this, the time to EEG normalization in children with absence epilepsy is poorly understood and may take months to years. This inherit discrepancy in treatment responsiveness and time to EEG normalization is concerning. One barrier may be access to EEG. This study sought to investigate the power of portable headband EEG in the detection of 3 Hz spike and wave ictal and interictal discharges compared to traditional EEG.
Methods:
A portable headband EEG from Brainbit was obtained to record brain waves in patients undergoing traditional follow up EEG with already diagnosed absence epilepsy. Recording from the headband EEG device and traditional EEG were obtained and analyzed. Blinded, independent reports were generated and compared to determine if headband EEG was as accurate as traditional EEG in the identification of abnormal EEG features. The headband EEG made by Brainbit is a portable, dry electrode EEG device that uses Bluetooth technology to record brainwaves from four electrodes approximated to T3, T4, O1, and O2. Study participants were recruited that were undergoing follow up EEG with previously diagnosed absence epilepsy.
Results:
A total of 10 patients were enrolled in the study. Headband EEG and traditional EEG were concordant in 80% of cases. The two cases that were discordant were false negatives on headband EEG. There were no false positive studies.
Conclusions:
The detection of absence seizures and associated discharges on headband EEG is feasible. Headband EEG recordings during abnormal epochs revealed high amplitude, slow waves consistent with a 3 Hz frequency. These waveforms significantly stood out from the background. Features of portable EEG that are appealing to patients and families include ease of recording, portability, and comfort. Limiting features include a limited array of electrodes, imperfect ability to penetrate through thick hair, and occasional poor connectivity without conducting substance on the dry electrodes.
Overall, this study suggests headband EEG may have a role in absence epilepsy follow up as a feasible, low-cost tool for screening of ictal and interictal discharges. In addition, this study supports the necessity for further improvement of technology to enhance the quality of captured waveforms and additional evaluation of utility portable headband EEG in diagnostic screening.
Funding: No funding