Electroencephalogram Utilization, Epileptiform Findings, and Associated Factors Among Children with Epilepsy in Southwestern Uganda: A 5-Year Retrospective Record Review

Abstract

Objective: Epilepsy is the most common neurological condition in children in Low and Middle Income Countries (LMIC). Although the diagnosis remains majorly clinical, EEG is fundamental in assessment and management of epilepsy. However, its uptake remains low in LMIC. We aimed to determine the proportion of children with epilepsy who have had an EEG, the proportion of epileptiform EEGs, and the factors associated with epileptiform EEGs among the children with epilepsy at a neurology clinic in South Western Uganda. Methods: We conducted a retrospective record review of 427 children less than 18 years old attending the Epilepsy Clinic at Mbarara Regional Referral Hospital. Records were selected by simple random sampling. A waiver of consent was obtained to study the medical records. Data was collected using REDCAP and analysed with STATA version 17. Proportions were reported as percentages and factors associated with epileptiform EEGs were analysed using the modified Poisson regression analysis. Results: Out of 427 participants in this study, 149 (34.9%) had done EEG. Epileptiform EEGs were observed among 102 (68.5%) children. The factors independently associated with epileptiform EEGs among the children with epilepsy included participants’ sex and type of seizure. Having an epileptiform EEG was 1.98 times more likely among females than males (cPR:1.98, P -value 0.005) while it was 1.87 times more likely in children with generalized seizures compared to those with focal seizures (cPR:1.87, P-value=0.019). Significance: There is need for more EEGs to be done especially among children with generalized seizures. More health workers also need to be trained in electro-encephalography.