Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia.

Background: Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. Methods: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020 and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. Conclusions: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors.

Electrodiagnostic referrals and neuromuscular disease pattern in East Africa: Experience from a tertiary hospital in Ethiopia.

Objective: We present a retrospective cross-sectional review of the electrodiagnostic (EDX) referral and diagnostic patterns in patients with suspected neuromuscular conditions at a tertiary hospital in Ethiopia. Methods: Between 2016 and 2019, 313 patients were evaluated at the EDX lab in Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia. In our patients, nerve conduction study and when appropriate needle electromyography was done. Demographic and clinical data were extracted from a digital registry. Results: Polyneuropathy (19.8%), carpal tunnel syndrome (12.1%), and lumbosacral radiculopathy (9.9 %) were the top three reasons for EDX referral in Ethiopia. Among them, polyneuropathy was the most frequent electrodiagnosis, where diffuse axonal and demyelinating subtypes accounted for 54% and 18.8%, respectively. Guillain-Barre syndrome was suspected in 18 patients and 15 had EDX confirmed motor axon polyneuropathy while three patients had demyelinating variant. Although a quarter (26.2%) of the referrals had a normal EDX, abnormal test results were significantly associated with weakness (95% CI: 3.29-7.04, p < 0.001), bound to wheelchair (95% CI: 1.86-2.87, p = 0.01) and having a specific diagnosis at time of referral (95% CI: 2.53-4.68, p = 0.007). Conclusions: Diffuse and entrapment neuropathies were the main reasons for electrodiagnosis test referrals in Ethiopia. Also, motor axonal variant was the most common type of inflammatory polyneuropathy diagnosed with EDX. Significance: Proper patient evaluation and documentation significantly improves the diagnostic yield and cost-effectiveness of EDX testing in a resource-poor countries like Ethiopia. This might be achieved through educating medical students, residents, and other care providers on the basics of EDX and its indications for correct use in the clinical care.