Development and validation of AIIMS modified INCLEN diagnostic instrument for epilepsy in children aged 1 month–18 years

Gulati, Sheffali; Patel, Harsh; Chakrabarty, Biswaroop; Dubey, Rachana; Arora, Narendra K.; Pandey, Ravindra M.; Paul, VK; Konanki, Ramesh; Anand, Vaishakh; Meena, Ajay Kumar

doi:10.1016/j.eplepsyres.2017.01.008

Cited by 9 publications

(4 citation statements)

References 23 publications

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“…The study was not designed to determine the social bias of “gender-selective treatments” on child survival, growth, and development [ 58 ]. The group has now validated a revised version of the Epi instrument to ascertain the types of Epi, including some of the ones not detected with the present tool [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India

et al. 2018

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BackgroundNeurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden.Methods and findingsWe assessed 3,964 children (with almost equal number of boys and girls distributed in 2–<6 and 6–9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size). These were from the North-Central, i.e., Palwal (N = 998; all rural, 16.4% non-Hindu, 25.3% from scheduled caste/tribe [SC-ST] [these are considered underserved communities who are eligible for affirmative action]); North, i.e., Kangra (N = 997; 91.6% rural, 3.7% non-Hindu, 25.3% SC-ST); East, i.e., Dhenkanal (N = 981; 89.8% rural, 1.2% non-Hindu, 38.0% SC-ST); South, i.e., Hyderabad (N = 495; all urban, 25.7% non-Hindu, 27.3% SC-ST) and West, i.e., North Goa (N = 493; 68.0% rural, 11.4% non-Hindu, 18.5% SC-ST). All children were assessed for vision impairment (VI), epilepsy (Epi), neuromotor impairments including cerebral palsy (NMI-CP), hearing impairment (HI), speech and language disorders, autism spectrum disorders (ASDs), and intellectual disability (ID). Furthermore, 6–9-year-old children were also assessed for attention deficit hyperactivity disorder (ADHD) and learning disorders (LDs). We standardized sample characteristics as per Census of India 2011 to arrive at district level and all-sites-pooled estimates. Site-specific prevalence of any of seven NDDs in 2–<6 year olds ranged from 2.9% (95% CI 1.6–5.5) to 18.7% (95% CI 14.7–23.6), and for any of nine NDDs in the 6–9-year-old children, from 6.5% (95% CI 4.6–9.1) to 18.5% (95% CI 15.3–22.3). Two or more NDDs were present in 0.4% (95% CI 0.1–1.7) to 4.3% (95% CI 2.2–8.2) in the younger age category and 0.7% (95% CI 0.2–2.0) to 5.3% (95% CI 3.3–8.2) in the older age category. All-site-pooled estimates for NDDs were 9.2% (95% CI 7.5–11.2) and 13.6% (95% CI 11.3–16.2) in children of 2–<6 and 6–9 year age categories, respectively, without significant difference according to gender, rural/urban residence, or religion; almost one-fifth of these children had more than one NDD. The pooled estimates for prevalence increased by up to three percentage points when these were adjusted for national rates of stunting or low birth weight (LBW). HI, ID, speech and language disorders, Epi, and LDs were the common NDDs across sites. Upon risk modelling, noninstitutional delivery, history of perinatal asphyxia, neonatal illness, postnatal neurological/brain infections, stunting, LBW/prematurity, and older age category (6–9 year) were significantly associated with NDDs. The study sample was underrepresentative of stunting and LBW and had a 15.6% refusal. These factors could be contributing to underestimation of the true NDD burden in our population.ConclusionsThe study identifies NDDs in childre...

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India

et al. 2018

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“…In a study, a program to diagnose epilepsy in children could detect epilepsy with a sensitivity of 91.5% and a specificity of 88.6%. 13 In another study, an application with 11 questions diagnosed epilepsy with 88% sensitivity and 100% specificity in adult patients. 14 Therefore, in cases where the patient cannot easily reach the physician, such as the pandemic period, telemedicine or other remote communication methods might help prevent delays in diagnosis and treatment…”

Section: Discussionmentioning

confidence: 97%

COVID-19 Pandemisinin Çocukluk Çağı Epilepsi Yönetimi Üzerindeki Etkileri; Anket Çalışması

Tekin¹,

Karaoğlu

2021

Osmangazi̇ Journal of Medicine

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The World Health Organization (WHO) declared the new coronavirus disease (COVID-19) pandemic on March 11, 2020. The pandemic has significantly impacted health systems worldwide, forcing them to reconsider the management of chronic diseases. Reorganization of health systems has inevitably prioritized the management of patients with COVID-19 infection, reducing hospital access for patients with other chronic diseases. Epilepsy is one of the most common chronic diseases of childhood, and pediatric neurologists have reviewed the methods they use in the management and treatment of epilepsy during pandemics. We organized a survey to evaluate the attitudes of pediatric neurologists in epilepsy management during the pandemic period. The 24-item questionnaire, created with Microsoft Forms, was sent to child neurologists via social communication platforms. Data were collected over two weeks. Variables were evaluated with Pearson chi-square and Student's t-test. Mann-Whitney U test and Student's t-test were used to compare the averages between the two groups. p <0.05 value was considered statistically significant. 118 participants (79 women and 39 men) who answered all the questions were included in the study. The mean age of the participants was 41.46±7.49 years, and the median child neurology experience was 6 years (3 months-36 years). The participants mostly postponed the outpatient clinic appointments of patients whose seizures were under control (77.5%). Most participants preferred to reduce the number or postpone electroencephalographies (EEG) during this period. The outpatient clinic visits of patients with well-controlled epileptic seizures can be postponed during the pandemic. In cases where face-to-face communication is not possible during the pandemic period, the patients' medical history and video images may help diagnose. The telemedicine method can also be useful in the post-pandemic period in the follow-up and management of patients with controlled epileptic seizures.

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“…There is certainly enough evidence here to justify the app being used in a larger population. Apps for epilepsy diagnosis and management are novel; as well as our epilepsy diagnosis app there is one other published app for episode diagnosis in children [22,23]. The WHO have also issued an app for diagnosis of episodes based on their mhGap intervention guide but the algorithm is not based on any published evidence [24].…”

Section: What?mentioning

confidence: 99%

The development of a smartphone application to help manage epilepsy in resource-limited settings

Patterson

2020

Seizure

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Epilepsy is treatable but in low-and middle-income countries (LMICs) it goes untreated with dire consequences for people with it and their families. There are not enough available doctors to treat it so it has been suggested that non-physician health workers (NPHWs) take a role in diagnosis and management. Tools will be essential to help them. A smartphone application (app) for episode diagnosis has proved safe and effective; this paper describes an app for epilepsy management. Methods: Questions were devised which captured temporal characteristics of episodes, diagnosis of episodes, seizure types, and epilepsy type, together with information on previous investigations, treatment, drug reactions, and current treatment. For untreated patients a management plan was suggested. The app generated a summary which could be sent to a remote specialist for advice. The finished app was evaluated in 23 people presenting with possible epilepsy by four doctors in training and one NPHW; its summary was compared to face-to-face evaluation by a neurologist. Results: The app was correct in 22 of 23 (96 %) patients for episode diagnosis, 2 of 2 for symptomatic seizures,18/20 (90 %) for epilepsy type and 9/10 (90 %) for treatment suggestion in untreated patients. The app took less than 15 min to complete. Conclusion:The initial results suggest that this management app is a worthwhile tool to help inexpert doctors or NPHWs manage suspected epilepsy. Its accuracy is well within reported inter-observer agreement. In its present form it requires input from a remote epilepsy specialist. This combination is a potential solution to managing epilepsy in LMICs.• offline where data is entered and the app produces output readable

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Development and validation of AIIMS modified INCLEN diagnostic instrument for epilepsy in children aged 1 month–18 years

Cited by 9 publications

References 23 publications

Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India

Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India

COVID-19 Pandemisinin Çocukluk Çağı Epilepsi Yönetimi Üzerindeki Etkileri; Anket Çalışması

The development of a smartphone application to help manage epilepsy in resource-limited settings

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