Reliability of the witness descriptions of epileptic seizures and psychogenic non-epileptic attacks: a comparative analysis

Abstract

Background:The diagnosis of epilepsy primarily depends on description of the observed seizure. The aim of this study was to determine the reliability of witness’ description among groups with different medical education.Methods:A group of 44 respondents (15 laymen, 15 medical students, and 14 doctors at neurology residency program) were shown video footages of focal epileptic seizure (ES) with secondary generalization and psychogenic non-epileptic seizure (PNES) of the same patient. The ability to describe ES and PNES characteristics, to estimate duration of seizures, and to detect of accurate seizure type was evaluated using a questionnaire. For the analysis of primary data obtained from questionnaires, we used descriptive statistical methods and methods for testing statistical hypotheses.Results:The sensitivity (Sn) and specificity (Sp) for accurate recognition of ES are different in the examined groups (laymen Sn = 53·3%, Sp = 33·3%; medical students Sn = 100%, Sp = 13·3%; neurology residents Sn = 100%, Sp = 71·4%). Evaluated duration of PNES and ES do not differ between examined groups. The impression that ES and PNES are distinct events is reciprocal for medical students and neurology residents, but not in laymen group. Neurology residents notice the essential characteristics of ES in high percentage.Conclusion:Accurate classification of the attacks is associated with the observers’ level of medical knowledge. Witnesses with specific, neurological knowledge with higher probability, compared to the laity and medical students, differentiate ES from PNES.