Abstract
Introduction: According to the ILAE, the definition of epilepsy requires the occurrence at least one epileptic seizure. Up to 20% of patients diagnosed of epilepsy are not actually epileptic. An accurate diagnosis is necessary for a satisfactory management of patients with Epilepsy. New broad access image technologies allow patients and families to record homemade videos helping neurologists in diagnosis. Method: During a two-year period in an epilepsy clinic, consecutive patients were encouraged to record their events with any available device. Instructions for good quality videos were given. Three neurologists/epileptologists watched the videos in clinical session, rated the quality of the recordings following some parameters and made a clinical diagnosis. In a second phase, previous diagnosis was revised. Results: 314 consecutive patients (relatives) were encouraged to record events. 52% male. Average age: 46 years. 267 patients had video recording devices available (87%) (Photo camera: 100%, cell-phone: 100%, webcam: 10%, video camera: 30%). From this group, 135 (50%) felt unable to record events. Reasons given: Low seizure frequency: 60%, seizures short duration: 80%. 50 events from 22 patients recorded. Mean age: 35 years. Seizure frequency three months prior to video deposit was 3, 5 seizures/patient/month. Previous epileptic syndrome diagnosed (based on description/neuroimaging/EEG): 15 focal temporal lobe epilepsy, 4 focal frontal probably symptomatic epilepsy, 3 epileptic encephalopathy. Type of seizures recorded: Focal motor with typical automatisms: 14 seizures/11 patients. Focal motor with hyperkinetic automatisms: 9 seizures/2 patients. Asymmetrical tonic motor seizures: 4 seizures/1 patient. Focal clonic seizure: 5 seizures/1 patients. Atypical absence seizure: 6 seizures/3 patients. Non-epileptic Seizure (NES): 13 seizures/3 patients. Postural tremor: 1 patient. There was agreement in diagnosis but in one. 18 patients were confirmed in their Diagnosis: Epilepsy misdiagnosis: 4. Three NES and one undetermined tremor. Conclusion: Homemade videos may be of diagnostic value in epilepsy management. Training in performing good-quality videos is necessary. Webcam long term recordings should be recommended as the best recording option.
Highlights
According to the International League against Epilepsy (ILAE), the definition of epilepsy requires the occurrence at least one epileptic seizure
Homemade videos may be of diagnostic value in epilepsy management
Published data confirms that up to 20% of patients diagnosed of epilepsy are not epileptic [3], that is, patients diagnosed of epilepsy have never had seizures, but other type of events
Summary
According to the ILAE, the definition of epilepsy requires the occurrence at least one epileptic seizure. An accurate diagnosis is necessary for a satisfactory management of patients with Epilepsy. According to the International League against Epilepsy (ILAE), the definition of epilepsy requires the occurrence of at least one epileptic seizure. The clinical diagnosis of epilepsy is not always easy, and is often made after several seizures. These descriptions are often inaccurate or incomplete and may mislead the clinician [2]. Published data confirms that up to 20% of patients diagnosed of epilepsy are not epileptic [3], that is, patients diagnosed of epilepsy have never had seizures, but other type of events. An accurate diagnosis is necessary for a satisfactory management of epileptic and non-epileptic patients
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