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Utilization and Yield of EEG in Pediatric and Adult referrals to the Neurology Unit A Akpalu, R Adigun, F Adzaku, B Quaye, A Suleman, Department of Medicine and Therapeutics, University of Ghana Medical School Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Introduction. Results.
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Utilization and Yield of EEG in Pediatric and Adult referrals to the Neurology UnitA Akpalu, R Adigun, F Adzaku, B Quaye, A Suleman, Department of Medicine and Therapeutics, University of Ghana Medical SchoolKorle Bu Teaching Hospital (KBTH), Accra, Ghana Introduction Results Figure 2b: Indications for Adult referrals to clinic The EEG is a valuable physiologic test ordered in a variety of conditions to determine the functional status of brain activity. In patients presenting with a variety of neurological manifestations (alterations in consciousness with or without motor involvement, encephalopathy, behavioral abnormalities, syncope, headaches, convulsions, and seizure activity), EEG recordings interpreted in the context of presenting clinical signs and symptoms can provide valuable information about the underlying cause(s) of the problem and guide the clinicians approach to treatment. To determine the yield of EEG in identifying functional abnormalities in the brain, we analyzed EEG recordings of 501 patients seen at Korle Bu Teaching Hospital EEG clinic in Ghana, West Africa. Figure 2a: Indications for Pediatric referrals Figure 1: Age and gender distribution of study population * Methods EEG recordings from 501 patients referred to the KBTH Neurology Unit between October 2009 and April 2010 were evaluated in the study. EEG variables recorded include; background activity, slow wave activity, fast wave activity, eye opening effect, hyperventilation, photic stimulation, and sleep patterns. We compared the referral diagnosis to the findings of the EEG. Referral diagnoses were classified into 11 categories (Fig2). Recordings were performed using a 19 channel Awake EEG recording with international 10/20 system of electrode placements. EEGs were categorized as: awake, sleep, sedation, sleep deprived (drowsy), and other (sleep deprived and sleep induced). Sedation was achieved using Chloral Hydrate or Promethazine. The EEG recordings were reported as “normal” or “abnormal” and the abnormality was categorized as; diffuse slowing, focal, or general spike and wave abnormalities. We evaluated the entire population and 2 subsets; Pediatrics (0 -12 years) and Adults (13 and above). Statistical analysis:Statistical analysis was performed using SPSS data editor version 17.0. Statistical significance was accepted at p<0.05 for Chi-Square Tests. p value < 0.001 Figure 3: EEG comments by age group Figure 4: Abnormality by age group Figure 4: Description of abnormalities by patient population Figure 5: Yield of EEGs in the evaluation of Neurological manifestations Conclusions • EEG abnormalities were seen in 49.1 % of patients ; 64.3% (pediatric ) vs. 37.8% (adult). EEG yield was highest in the diagnosis of general spike and wave abnormalities in both populations, 40.8% (pediatric) vs. 56.8 % (adult) in comparison to focal abnormalities. Abnormal waveform and discharges were highest in patients referred to the Neurology unit with convulsive episodes, known seizure disorders, newly diagnosed seizures, and neurodevelopmental delays respectively. While the EEG is not a definitive test, it provides useful information in addition to the presenting signs and symptoms to determine the presence of functional abnormalities in the brain. Acknowledgements We thank the EEG Clinic Staff and Medical Unit III personnel for their support of this project
Paper information will be here when you get here. The Cardiac values come from then transthoracic echocardiogram they have done when they are here. We thank the EEG Clinic Staff and Medical Unit III personnel for their support of this project