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01/10/2014

Got epilepsy? Now there's an app for that

Epilepsy

Photo credit: Arek Stopczynski

In June, I visited the secluded Himalayan kingdom of Bhutan and spent a few days shadowing the country's first psychiatrist, Dr. Chencho Dorji.

When I visited Dr. Chencho's office, his waiting area was rammed with patients, some of whom had travelled for days to reach the country's only psychiatric department. Traversing this rugged, mountainous country is no small feat, either – it requires days of driving along winding, cliff-skirting roads (often prone to mudslides during the rainy season) or even traveling by foot.

To better reach patients in remote areas, Bhutan has established a network of health centres across the country, all staffed by minimally-trained health workers. And thanks to Dr. Chencho, these workers have also been trained to recognize mental health disorders.

The system has been successful – but it hasn't really helped Bhutan's estimated 10,000 people who suffer from epilepsy. Diagnosing epilepsy is complicated and Bhutan only has one EEG machine, one that often breaks down, and it's based in the capital city, Thimphu. Giving Bhutan more EEG machines won't help much, either; interpreting the results would require a level of training that just isn't practical for community health workers.

And so, many Bhutanese have to travel to Thimphu for an epilepsy diagnosis – or, as is probably more often the case, they just never get diagnosed.

This puts many Bhutanese at risk, says Dr. Chencho, who is currently on leave in Australia. As he wrote to me in an email:

"Epilepsy patients do not receive optimal care and treatment because of a number of reasons, such as lack of awareness of the disease, belief in supernatural causes, stigma and ... lack of skills and knowledge among health providers. As a consequence, many epilepsy patients hide in their houses without treatment for fear of being known and discriminated by society. Many of them sustain burns (when they have seizures and fall) and those who survive live with scars and disabilities."

In Bhutan, there is another major problem when it comes to treating epilepsy: the country still does not have a single neurologist. As a result, psychiatrists like Dr. Chencho have taken up the task of treating the neurological disorder and only 3,000 epilepsy patients have been screened, diagnosed, and put on anti-epileptic drugs, Dr. Chencho says.

But a solution may soon be forthcoming – thanks, in part, to Canada.

Today, Grand Challenges Canada – a federally-funded non-profit organization – announced $7.7 million in funding for 22 health projects around the world.

One of the grantees is the Bhutan Epilepsy Project, which has invented a $300 device and smartphone app for diagnosing epilepsy. The device, developed with the help of University of Ottawa reserachers, is basically a portable EEG device – one that will soon be tested in Bhutan.

As the press release explains, a typical EEG test involves placing electrodes on the scalp to detect tiny electrical impulses produced by the brain. The device is connected by wires to a speaker and recording machine, which translates the brain's electrical signals into wave patterns that can be viewed on a computer.

This new device includes a cap that connects 14 electrode leads on the scalp and a headphone jack that connects to a tablet or smartphone. Data captured by the device can then be sent through a cellular network to specialists anywhere in the world.

 

"The ultimate goal: to enable a community-level primary health care worker anywhere in the world to diagnose seizure disorders," said the Grand Challenges Canada press release. "In the case of epilepsy, it can be treated with drugs that are both effective and inexpensive (as little as a few cents a day)."

Dr. Chencho, who is a partner on the Bhutan Epilepsy Project, thinks the device could have a huge impact in countries like Bhutan. It will be affordable, convenient for the patient, and increase the country's capacity for diagnosing epilepsy cases, he says.

"As of now, even in the industrialized countries ... patients have to be admitted to hospitals and monitored over days and weeks until they get seizures and are recorded on EEG machines," he wrote in his email.

"So this technology will definitely benefit Bhutan and other countries which have difficulty in accessing hospital and health care services."

The project leader is Dr. Farrah Mateen, a neurologist with both the University of Ottawa and the Massachusetts General Hospital of Harvard Medical School. You can watch a video of her explaining the project here.

Jennifer Yang is the Star’s global health reporter. Follow her on Twitter: @jyangstar

 

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