Eszter Nagy, Alexandra Major, Nelli Farkas and Katalin
Hollódy. Epileptic seizure or not? Proportion
of correct judgment based only on a video recording of a paroxysmal event. Seizure.
In press.
Highlights
• Correct diagnosis of infantile seizures without history
and EEG is extremely hard.
• Correct epilepsy recognition grows proportionally with
professional qualification.
• Experience and education improve the accuracy of seizure
recognition.
Abstract
Purpose
Our study was intended to measure the proportion of correct
seizure recognition among different medical and non-medical groups based on
only a video recording.
Methods
Video recordings about paroxysmal movements of 15 very young
infants (2 days − 5 months of age) were displayed for six groups: 159 1st-year
medical students, 65 4-5th-year medical students, 52 paediatric residents, 18
paediatric neurologists from different European countries, 43 adult
neurologists and 37 parents whose children were treated at our Department with
epilepsy. All participants were asked to decide which recording they considered
as of epileptic origin or a non-epileptic event. Correct answer rate (CAR) was
calculated in each group for every video.
Results
The average CAR was the lowest in the group of 1st-year
medical students (36.6%), the best results were reached by paediatric
neurologists (67.4%). The CAR was significantly different between the groups of
1st-year medical students and paediatric neurologists (p = 0.02), and between
the groups of 1st-year medical students and residents (p = 0.045). The CAR of
the most deceptive epileptic seizure was only 18.2%. The judgement of parents
with epileptic children proved to be better than that of the 1st-year medical
students.
Conclusions
Recognising epileptic seizures in very young infants without
EEG is extremely inaccurate. Even trained paediatric neurologists were able to
judge correctly the different movement types in only 67.4% of the cases. The
role of education and experience is clearly indicated by the increase in CAR
from 1st-year medical students through well–trained paediatric neurologists.
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