We conducted a case-control study of 33 Jamaican children 7 to 12 years old with uncomplicated ep... more We conducted a case-control study of 33 Jamaican children 7 to 12 years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p b 0.05), language (p b 0.05), and attention (p b 0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient = −0.14, CI: − 0.23, − 0.05), language (coefficient = −0.13, CI: −0.23, −0.04), and mathematics ability (coefficient = −0.01, CI: −0.02, −0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.
Objectives: To assess the validity and reliability of a screening questionnaire administered to p... more Objectives: To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. Study Design and Setting: We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists' offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. Results: The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to !1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P ! 0.01). Conclusion: The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
Myasthenia gravis is uncommon in children. The clinical characteristics in children of the Englis... more Myasthenia gravis is uncommon in children. The clinical characteristics in children of the English-speaking Caribbean have not been documented previously. To describe the clinical characteristics and outcome of children with myasthenia gravis at two tertiary hospitals in Jamaica. The case-notes of all children with a diagnosis of myasthenia gravis managed at the University Hospital of the West Indies and Bustamante Hospital for Children between January 1994 and December 2005 were reviewed. There were 34 children; mean age of onset of illness was 7.5 years and mean period of follow-up was 38.5 months. The male-to-female ratio was 1:1.3. Nineteen (59%) presented with ocular manifestations; 47% of these developed signs of generalised involvement. Most were treated with pyridostigmine and prednisone. Eight patients had thymectomy. Four patients (12%) entered remission. There were two deaths. Myasthenia gravis in Jamaican children is similar to that in other populations. It is more commo...
Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differe... more Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differences in reports, the aim was to evaluate sleep and behavior in Jamaican CWE and determine any association with epilepsy-related variables. Children with epilepsy were identified along with age and gender-matched controls from the University Hospital of the West Indies and the Bustamante Hospital for Children. Written informed consent was obtained followed by the completion of questionnaires assessing sleep, behavior, and background of both cases and controls. Parents of 61 children (26 cases and 35 controls) participated in the study. There was no difference in sleep scores or frequency of sleep disorders between cases and controls (p > 0.05). Children with epilepsy had worse scores than controls in peer problems (3.85 vs 2.32, p < 0.01), internal problems (7.42 vs 4.71, p < 0.01), and total behavioral problem (16.27 vs 12.09, p < 0.01). When compared with controls, CWE had a higher frequency of abnormal peer problems (66% vs 32%, p < 0.05) and emotional problems score (42% vs 15%, p < 0.05). Children with learning difficulty were three times more likely to have abnormal behavioral score Odds Ratio (OR) = 3.818, p < 0.05). Jamaican CWE have similar sleep scores to their healthy peers but have a higher frequency of peer and emotional problems.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
We conducted a case-control study of 33 Jamaican children 7 to 12 years old with uncomplicated ep... more We conducted a case-control study of 33 Jamaican children 7 to 12 years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p b 0.05), language (p b 0.05), and attention (p b 0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient = −0.14, CI: − 0.23, − 0.05), language (coefficient = −0.13, CI: −0.23, −0.04), and mathematics ability (coefficient = −0.01, CI: −0.02, −0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.
Objectives: To assess the validity and reliability of a screening questionnaire administered to p... more Objectives: To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. Study Design and Setting: We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists' offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. Results: The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to !1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P ! 0.01). Conclusion: The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
Myasthenia gravis is uncommon in children. The clinical characteristics in children of the Englis... more Myasthenia gravis is uncommon in children. The clinical characteristics in children of the English-speaking Caribbean have not been documented previously. To describe the clinical characteristics and outcome of children with myasthenia gravis at two tertiary hospitals in Jamaica. The case-notes of all children with a diagnosis of myasthenia gravis managed at the University Hospital of the West Indies and Bustamante Hospital for Children between January 1994 and December 2005 were reviewed. There were 34 children; mean age of onset of illness was 7.5 years and mean period of follow-up was 38.5 months. The male-to-female ratio was 1:1.3. Nineteen (59%) presented with ocular manifestations; 47% of these developed signs of generalised involvement. Most were treated with pyridostigmine and prednisone. Eight patients had thymectomy. Four patients (12%) entered remission. There were two deaths. Myasthenia gravis in Jamaican children is similar to that in other populations. It is more commo...
Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differe... more Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differences in reports, the aim was to evaluate sleep and behavior in Jamaican CWE and determine any association with epilepsy-related variables. Children with epilepsy were identified along with age and gender-matched controls from the University Hospital of the West Indies and the Bustamante Hospital for Children. Written informed consent was obtained followed by the completion of questionnaires assessing sleep, behavior, and background of both cases and controls. Parents of 61 children (26 cases and 35 controls) participated in the study. There was no difference in sleep scores or frequency of sleep disorders between cases and controls (p > 0.05). Children with epilepsy had worse scores than controls in peer problems (3.85 vs 2.32, p < 0.01), internal problems (7.42 vs 4.71, p < 0.01), and total behavioral problem (16.27 vs 12.09, p < 0.01). When compared with controls, CWE had a higher frequency of abnormal peer problems (66% vs 32%, p < 0.05) and emotional problems score (42% vs 15%, p < 0.05). Children with learning difficulty were three times more likely to have abnormal behavioral score Odds Ratio (OR) = 3.818, p < 0.05). Jamaican CWE have similar sleep scores to their healthy peers but have a higher frequency of peer and emotional problems.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
To assess the validity and reliability of a screening questionnaire administered to parents/careg... more To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician.
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