Smartphone EEG Utility and Quality for Epilepsy Patients in the West African Republic of Guinea (196)

Objective: To assess the applicability of a smartphone-based electroencephalography (EEG), the Smartphone Brain Scanner-2 in a low-income country, including quality of results and usefulness of repeat testing. Background: People with epilepsy in Sub-Saharan Africa are often undiagnosed. We examine a low-cost, portable smartphone-based EEG technology in a heterogeneous epilepsy cohort in the West African Republic of Guinea. Design/Methods: The SBS2 system consists of an Android tablet wirelessly connected to a 14-electrode EasyCap headset. SBS2 was performed in people with suspected epilepsy in Guinea (2018–19), with a repeat EEG carried out at a variable time interval. Recordings were interpreted by U.S., Canadian, and U.K. experts in Clinical Neurophysiology. Results: We included 149 participants (41% female, median age 17.9 years). 66.6% ≤ 21 years; mean number of seizures per month 5.7 +/−15.5. The mean duration of EEG1 was 53 minutes +/−12.3 and EEG2 was 29.6 minutes +/−12.8. The mean quality score of EEG1 and EEG2 independently was 6.4 (range 1(low)-10(high), median 7.0). 29.5% of participants had epileptiform discharges (EDs) at EEG1 and 16.7% at EEG2. 41.6% had abnormal slowing and/or EDs at EEG1 and 28.8% at EEG2. 26.1% were recommended for neuro-imaging after EEG1 and 14.7% after EEG2. Of those without EDs at EEG1 (n=53, 55.8%), 7 (13.2%) had EDs at EEG2. Of those with detectable EDs on EEG1 (n = 23, 24.2%), 12 (52.1%) did not have EDs at EEG2. Patients for whom at least one EEG was not scored for EDs were excluded from the comparative ED analysis (n = 54, 36%). Conclusions: The SBS2 has a reproducible level of quality on repeat testing and is useful for the detection of EDs. One EEG of approximately 50 minutes was adequate to support diagnosis. The need for neuroimaging access in this patient population is evident. Disclosure: Dr. Ayub has nothing to disclose. Dr. Leung has nothing to disclose. Dr. Fantaneanu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with UCB, Eisai, and Sunovion. Dr. Patel has nothing to disclose. Dr. Vyas has nothing to disclose. Dr. Milligan has nothing to disclose. Dr. Villamar has nothing to disclose. Dr. Hoch has nothing to disclose. Dr. Purves has nothing to disclose. Dr. Esmaeili has nothing to disclose. Dr. Tellez-Zenteno has nothing to disclose. Dr. Gonzalez-Giraldo has nothing to disclose. Dr. Tolokh has nothing to disclose. Dr. Heidarian has nothing to disclose. Dr. Worden has nothing to disclose. Dr. Jadeja has nothing to disclose. Dr. Fridinger has nothing to disclose. Dr. Lee has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Receive clinical trial funds from Novartis Canada, Roche Canada Serve on ad boards for Celgene, Novartis Canada, Roche Canada, Teva Neuroscience, Serono Canada, Genzyme Canada, Biogen Canada. Dr. Lee has received research support from Receive clinical trial funds from Novartis Canada, Roche Canada Serve on ad boards for Celgene, Novartis Canada, Roche Canada, Teva Neuroscience, Serono Canada, Genzyme Canada, Biogen Canada. Dr. Cisse has nothing to disclose. Dr. Mateen has received research support from IQVIA.