Improving Treatment for Ugandan Children with Epilepsy

October 08, 2021

Pediatric specialists at Ann & Robert H. Lurie Children’s Hospital of Chicago regularly treat children who come from outside of Chicago’s borders. This year, the hospital’s specialists within the Divisions of Neurosurgery and Neurology have taken their expertise to a different continent.

Some of the medical officers undergoing EEG training to help treat children with epilepsy in Mbale, Uganda, are pictured here

In a collaboration launched earlier this year, Lurie Children’s specialists are working with doctors at CURE Children's Hospital of Uganda. This east African hospital is one of eight pediatric hospitals of the global network run by CURE International, a nonprofit that provides surgical care to children with disabilities.

Over the past decade, Erik Padilla, Director of Diagnostics for the Epilepsy Center at Lurie Children’s, along with pediatric neurodiagnostic technologists and epileptologists have developed and run a rigorous neurodiagnostics training program in Chicago. Now, using a modified curriculum on an interactive web-based platform, Erik Padilla and the Lurie Children's team are training doctors based in the city of Mbale, a town in the southeastern part of Uganda. The providers are learning to configure and use industry-donated equipment perform electroencephalograms, or EEGs, a test that helps determine where in the brain seizures are coming from. That information is crucial to the diagnosis of epilepsy.

Along with neuroimaging such as MRI of the brain, EEG is the study that is needed for appropriate testing of patients with seizures.

Dr. Sandi Lam.jpg

Dr. Sandi Lam

“Using that information, we can help identify who may benefit from surgery to treat epilepsy,” said Dr. Sandi Lam, Head of Lurie Children’s Division of Neurosurgery. For certain patients, surgery can result in a cure for their epilepsy.

Currently, there are at least 1,000 children in the Mbale area who are being treated for seizures; however, they have not received EEGs to help determine where the seizures are coming from, Dr. Lam said.

“Surgery to treat epilepsy often involves operating on the part of the brain that is involved in the start of seizure activity. We must verify this information with an EEG in order to plan safe and effective epilepsy surgery,” Dr. Lam said.

With this developing collaboration at the midway point of the first cohort of Ugandan doctors involved in the curriculum, the team in Uganda is now able to succesfully perform EEGs on their patients. In time and with collaboration, the team will identify select patients who can benefit from surgeries to treat epilepsy.

The partnership aims to improve care for thousands of children with epilepsy in a country where pediatric subspecialists are a rarity. There is only one dedicated pediatric neurologist in Uganda, Dr. Lam said, which has a population of about 47 million. About half of the country’s population is under age 15, and 80 percent of the youth population live in rural areas, such as the area surrounding Mbale. The CURE Children's Hospital of Uganda is a unique beacon of world-class care for children with neurological conditions, Dr. Lam said.

“It is possible that a majority of these children’s seizures can be cured or well-controlled with appropriate medical treatment or surgical options,” Dr. Lam said. “This collaboration will make those highly effective treatment options more accessible.”

Enrollment for the web-based EEG curriculum was donated to the Uganda-based doctors by ASET-The Neurodiagnostic Society, a professional association for neurodiagnostic professionals involved in the study and recording of electrical activity in the brain and nervous system. ASET’s Mission is to provide leadership, advocacy and resources that promote professional excellence, patient safety and quality of care, in Neurodiagnostics. A member of ASET’s Department of Education staff has contributed to this important educational endeavor by teaching several lessons from the curriculum.

When COVID-19 restrictions on travel lift, Dr. Lam will continue her visits to sub-Saharan Africa and looks forward to bringing along with members of the Lurie Children’s team to Mbale. Meanwhile, Ugandan doctors from CURE Children's Hospital will make the trip to Lurie Children’s for additional knowledge and skill-sharing.

“This is a unique opportunity for both institutions to help get premier epilepsy care to as many children as possible,” Dr. Lam.