Utilizing a wearable smartphone-based EEG for pediatric epilepsy patients in the resource poor environment of Guinea: A prospective study. (N5.001)

Objective: To compare the ability of a smartphone-based app, the Smartphone Brain Scanner-2(SBS2), and pre-placed EEG cap (Easycap), costing ~300USD, to detect abnormalities with that of standard EEG. Background: There is a need for reliable, accessible and cost efficient EEG technologies in resource-limited settings. The SBS-2 is a portable, wearable device utilizing a 14 channel EasyCap administered by personnel easily after a few hours training. Data are transmitted via a wireless android tablet and read remotely by specialist neurophysiologists. Design/Methods: Children were enrolled at Ignace Deen Hospital, Conakry, in November 2017. Participants met the ILAE definition of epilepsy and sequentially had a standard 21 lead Xltek EEG and a 14 lead EasyCap EEG utilizing SBS-2 technology. EEGs were read remotely by specialist clinical neurophysiologists in the USA and Canada. Quality scores (0–10, 0 being totally uninterpretable, 10 perfect ) were also provided. Results: 97 patients (49 male, mean age 10 years) were enrolled. One standard (1.0%) and 11(11.3%) of SBS-2 EEGs were uninterpretable due to artefact. Mean quality scores were 7.37 and 6.76 for standard and SBS-2 EEG. Two patients had a standard EEG but not an SBS-2 EEG, yielding 83 pairs of studies for analysis. Mean recording time for standard and SBS-2 EEGs was 22.9 and 27.9 minutes respectively. Fifty-six(67.4%) standard EEGs and 31(37.3%) SBS-2 EEGs were abnormal. The sensitivity and specificity for any abnormality was 0.52 (CI 0.378,0.658) and 0.93 (CI 0.801,1.00). Epileptiform discharges were detected on 21 (25.3%) SBS-2 and 30 (36.1%) of standard EEGs. The SBS-2 had a sensitivity of 0.52 (CI 95% 0.324,0.708) and a specificity of 0.90(CI 95% 0.814,.944) for epileptiform discharges with positive and negative predictive values of 0.762 and 0.758. Conclusions: The SBS-2 application and EasyCap wearable device is easy to administer, moderately sensitive but highly specific for detection of EEG and epileptiform abnormalities in pediatric epilepsies. Disclosure: Dr. Williams has nothing to disclose. Dr. Cisse has nothing to disclose. Dr. Schaekermann has nothing to disclose. Dr. Sakadi has nothing to disclose. Dr. Tassiou has nothing to disclose. Dr. Bah has nothing to disclose. Dr. Djibo Hamani has nothing to disclose. Dr. Lim has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Phillips-Respironics. Dr. Leung has nothing to disclose. Dr. Fantaneau has nothing to disclose. Dr. Milligan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Khatri has nothing to disclose. Dr. Hoch has nothing to disclose. Dr. Vyas has nothing to disclose. Dr. Lam has nothing to disclose. Dr. Hotan has nothing to disclose. Dr. Cohen has nothing to disclose. Dr. Law has nothing to disclose. Dr. Mateen has nothing to disclose.