Electro encephalography screening of suspected epileptic patients in Erbil City

  • Mutaz F. Hummadi Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
Keywords: Erbil, Epilepsy, EEG, Sensitivity, Specificity

Abstract

Background and objective: Electroencephalography is an essential component in the evaluation of patients with epilepsy. Electroencephalography provides important information about background electroencephalography and epileptiform discharges and the interictal spike or sharp waves. This study aimed to differentiate between epileptic and non-epileptic patients through electroencephalography investigation and determine its relationship with certain socio-demographic and clinical characteristics.

Methods: In this cross-sectional study included 400 cases (205 males and 195 females) with a mean age ± SD of 25 ± 14 years, referred to the private neurology clinic, Soran Medical Center between April 2013 and March 2017 for attacks of abnormal movements and or disturbed level of consciousness.

Results: Age-related prevalence of epilepsy showed a significantly higher prevalence (P = 0.001) of the disease among those who were 20 years and more. Epileptic patients showed significantly (P = 0.001) higher sharp slow waves and sharp waves, which were mainly dominated by parietal and occipital regions of the brain. Electroencephalography finding showed higher Beta rhythm followed by Alpha and Delta rhythms (73.5%, 14.3% and 9.0%, respectively), Patients with epilepsy (generalized and focal) had shown best rhythm adoption in Beta rhythm (75.2% and 70.2%, respectively), followed by Alpha rhythm (13.2% and 14.8%, respectively). Focal to bilateral (secondary generalized) and generalized motor epilepsy were the most common diagnosis among the epileptic cases (45.4% and 43.4%, respectively). The overall sensitivity of electroencephalography was 67.8%, and specificity was 63.5%.

Conclusion: The electroencephalography showed good sensitivity and specificity in diagnosing suspected epileptic patients, with interesting higher sensitivity than specificity. Not only the abnormal discharges, but the background dominating activity and the best rhythm adoption can help in the diagnosis of epilepsy.

References

Sheth RJ, Benbadis SR. EEG in Common Epilepsy Syndromes; 2016. (Accessed July 23, 2017, at http://emedicine.medscape.com/article/1138154-overview).

Zubcevic S, Milos M, Catibusic F, Uzicanin S, Krdzalic B. Interictal Electroencephalography (EEG) findings in children with epilepsy and bilateral brain lesions on Magnetic Resonance Imaging (MRI). Acta Inform Med 2015; 23:343–6.

Siddiqui M, Yaqoob U, Bano A, Malik A, Khan FS, Siddiqui K. EEG findings in post stroke seizures: an observational study. Pak J Med Sci 2008; 24:386–9.

Pal SK, Sharma K, Prabhakar S, Pathak A. Neuroepidemiology of epilepsy in Northwest India. Annal Neurosci 2010; 17:160–6.

Turner K, Piazzini A, Chiesa V, Barbieri V, Vignoli A, Gardella E, et al. Patients with epilepsy and patients with psychogenic non-epileptic seizures: Video- EEG, clinical and neuropsychological evaluation. Seizure 2011; 20:706–10.

Al-Kattan M, Afifi L, Shamloul R, Mostafa E. Assessment of precipitating factors of breakthrough seizures in epileptic patients. Egypt J Neurol Psychiat Neurosurg 2015; 52:165–71.

Yazdi MR, Farsi Baf MM, Afsari A, Alipour A, Khorashadizadeh M, Ghiassi PK, et al. Clinical features of epilepsy at 2 referral hospitals in Northern Iran. Neurosciences 2015; 20:243–7.

Camfield P1, Camfield C. Incidence, prevalence and etiology of seizures and epilepsy in children. Epileptic Disord 2015; 17:117–23.

Hamdy NA. Prevalence of Epilepsy in primary school children in El- Minia City. Egypt. Egypt J Neurol Psychiat Neurosurg 2009; 46(1):33–9.

Hamdy NA, Alamgir JA, Mohammad EE, Khedr MH, Fazili S. Profile of epilepsy in a regional hospital in Al Qassim, Saudi Arabia. Int J Health Sci 2014; 8:247–55.

Benbadis S. The differential diagnosis of epilepsy: A critical review. Epilepsy Behav 2009; 15:15–21.

Deme S. A study of correlation of CT scan brain and EEG in epilepsy. Int Arch Integ Med 2016; 3:55–60.

Iraq, the population of the provinces and province capitals of the Republic of Iraq. (Accessed July 25, 2017, at http://www.citypopulation.de/Iraq.html).

Pal SK, Sharma K, Prabhakar S, Pathak A. Neuro-epidemiology of Epilepsy in Northwest India. Ann Neurosci 2010; 17:160–6.

Chowdhury AH, Chowdhury RN, Khan SU, Ghose SK, Wazib A, Alam I, et al. Sensitivity and specificity of Electroencephalography (EEG) among patients referred to an electrophysiology Lab. In Bangladesh. J Dhaka Med Coll 2014; 23(2):215–22.

Khatri IA, Iannaccone ST, Ilyas MS, Abdullah M, Saleem S. Epidemiology of epilepsy in Pakistan: Review of literature. J Pak Med Assoc 2003; 53:594–7.

Al- Sulaiman AA, Ismail HM. Clinical pattern of newly-diagnosed seizures in Saudi Arabia: a prospective study of 263 children. Childs Nerv Syst 1999; 15:468–71.

Hashem S, Al-Kattan M, Ibrahim SY, Shalaby NM, Shamloul RM, Farrag M. Epilepsy prevalence in Al-Manial Island, Egypt. A door-to-door survey. Epilepsy Research 2015; 117:133–7.

Deme S. A study of correlation of CT scan brain and EEG in epilepsy. Int Arch Integ Med 2016; 3:55–61.

Hawley SR, Ablah E, Hesdorffer D, Pellock JM, Lindeman DP, Paschal AM, et al. Prevalence of pediatric epilepsy in low-income rural Midwestern counties. Epilepsy Behav 2015; 53:190–6.

Baheti R, Gupta BD, Baheti R. A Study of CT and EEG findings in patients with generalized or partial seizures in Western Rajasthan. Ind Acad Clin Medi 2003; 4:25–9.

Bhuyan R, Jahan W, Upadhyaya N. Interictal wave pattern study in EEG of epilepsy patients. Int J Res Med Sci 2017; 5:3378–84.

Oguri M, Saito Y, Fukuda C, Kishi K, Yokoyama A, Lee S. Distinguishing acute Encephalopathy with biphasic seizures and late reduced diffusion from prolonged febrile seizures by acute phase EEG spectrum analysis. Yonago Actamedica 2016; 59:1–14.

Bjørk MH, Sand T, Bråthen G, Linaker OM, Morken G, Brigt M, et al. Quantitative EEG findings in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department. BMC Psychiatry 2008; 8:89:1–8.

Geut I, Weenink S, Knottnerus IL. Detecting interictal discharges in first seizure patients: ambulatory EEG or EEG after sleep deprivation. Seizure 2017; 51:52–4.

Published
2019-08-06
How to Cite
Hummadi, M. (2019). Electro encephalography screening of suspected epileptic patients in Erbil City. Zanco Journal of Medical Sciences (Zanco J Med Sci), 23(2), 184-193. https://doi.org/10.15218/zjms.2019.024
Section
Original Articles