Tablet‐based electroencephalography diagnostics for patients with epilepsy in the West African Republic of Guinea

Background and purposeEpilepsy is most common in lower-income settings where access to electroencephalography (EEG) is generally poor. A low-cost tablet-based EEG device may be valuable, but the quality and reproducibility of the EEG output are not established.MethodsTablet-based EEG was deployed in a heterogeneous epilepsy cohort in the Republic of Guinea (2018-2019), consisting of a tablet wirelessly connected to a 14-electrode cap. Participants underwent EEG twice (EEG1 and EEG2), separated by a variable time interval. Recordings were scored remotely by experts in clinical neurophysiology as to data quality and clinical utility.ResultsThere were 149 participants (41% female; median age 17.9 years; 66.6% ≤21 years of age; mean seizures per month 5.7 ± SD 15.5). The mean duration of EEG1 was 53 ± 12.3 min and that of EEG2 was 29.6 ± 12.8 min. The mean quality scores of EEG1 and EEG2 were 6.4 [range, 1 (low) to 10 (high); both medians 7.0]. A total of 44 (29.5%) participants had epileptiform discharges (EDs) at EEG1 and 25 (16.8%) had EDs at EEG2. EDs were focal/multifocal (rather than generalized) in 70.1% of EEG1 and 72.5% of EEG2 interpretations. A total of 39 (26.2%) were recommended for neuroimaging after EEG1 and 22 (14.8%) after EEG2. Of participants without EDs at EEG1 (n = 53, 55.8%), seven (13.2%) had EDs at EEG2. Of participants with detectable EDs on EEG1 (n = 23, 24.2%), 12 (52.1%) did not have EDs at EEG2.ConclusionsTablet-based EEG had a reproducible quality level on repeat testing and was useful for the detection of EDs. The incremental yield of a second EEG in this setting was ~13%. The need for neuroimaging access was evident

Herkunft numerischer und struktureller Aberrationen des X-Chromosoms

Nachdem 1956 durch Tjio und Levan die Darstellung der Metaphasenchromosomen eingeführt worden war, wurden in kurzer Folge ab 1959 verschiedene menschliche Aneuploidien als Ursache häufiger und z.T. bereits vorher bekannter klinischer Syndrome entdeckt (47,XXY als Ursache des Klinefelter-Syndroms: Jacobs u. Strong 1959; Trisomie 21 beim Down-Syndrom: Lejeune et al. 1959; 45,X als Basis des Turner-Syndroms: Ford et al. 1959). Später stellte sich heraus, daß fast die Hälfte der Patienten mit den klinischen Befunden des Turner-Syndroms 46 Chromosomen besitzt, aber entweder ein Mosaik oder eine strukturelle Aberration eines X-Chromosoms oder beides aufweist (Schmid et al. 1974)