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Abstract Details

Concordance Between Patient-Reported And Physician-Reported Seizure Semiology
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
039
The objective of this study is to evaluate the concordance of patient-reported seizure semiology with physician-reported semiology.
Recognizing and describing seizure semiology is crucial in the diagnosis, evaluation, and management of epilepsy and is essential in pre-surgical evaluation for intractable epilepsy.
Chart data from 201 patients during their epilepsy monitoring unit (EMU) evaluations from October 2016 to October 2017 were retrospectively reviewed. Seizure semiology described by patients was compared to physician-reported semiology during the EMU stay. Semiology was scored across categories: aura, onset, motor and non-motor features, and postictal states, as well as their characteristics. Patients with non-diagnostic EMU evaluations were excluded due to inability to compare patient and physician descriptions of semiology.
Statistical analysis for concordance using Cohen’s kappa coefficient was conducted across the categories for 128 of 201 patients. Four categories were in moderate agreement: presence or absence of focal non-motor spell and its characteristics with kappa scores of 0.54 and 0.45, respectively; presence or absence of focal motor spell and its characteristics with scores of 0.56 and 0.41, respectively; presence or absence of generalized motor spell and its characteristics with scores of 0.60 and 0.59, respectively; and presence or absence of generalized non-motor spell and its characteristics with scores of 0.50 and 0.51, respectively. The remaining two categories were in fair agreement: presence or absence of aura and its characteristics with scores of 0.33 and 0.37, respectively; and presence or absence of postictal state and its characteristics with scores of 0.30 and 0.23, respectively. Each score had a p-value of less than 0.01.
Concordance of patient-reported and physician-reported semiology varies widely but agreement is higher for categories pertaining to ictal state compared to preictal and postictal states. Further studies are needed to determine if improved concordance is a positive prognostic factor for post-treatment seizure freedom.
Authors/Disclosures
Andrew Lin, MD (UT Austin Health Dell Medical School)
PRESENTER 		Dr. Lin has nothing to disclose.
Patrick Arraj Mr. Arraj has nothing to disclose.
Mark Agostini, MD (U.T. Southwestern Medical Center) Dr. Agostini has nothing to disclose.
Sasha Alick-Lindstrom, MD, MPH FACNS, FAES, FÂ鶹´«Ã½Ó³»­ (UT Southwestern Medical Center) Dr. Alick-Lindstrom has nothing to disclose.
Rohit Das, MD, FÂ鶹´«Ã½Ó³»­ (VA Portland Healthcare System) Dr. Das has received personal compensation for serving as an employee of Oregon Health Science University. Dr. Das has received personal compensation in the range of $10,000-$49,999 for serving as a Physician Advisor with Concentra .
Hina N. Dave, MD (Debakey VA hospital) Dr. Dave has nothing to disclose.
Marisara Dieppa, MD (University of Texas SW Medical School) Dr. Dieppa has nothing to disclose.
Kan Ding, MD (UT Southwestern Medical Center) The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS.
J. H. Harvey, DO (UT Southwestern Medical Center) Dr. Harvey has received personal compensation for serving as an employee of Neuralogix. Dr. Harvey has received personal compensation for serving as an employee of Integris . Dr. Harvey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Harvey has stock in Epiminder.
Ryan Hays, MD, MBA, FAES, FÂ鶹´«Ã½Ó³»­ (UT Southwestern Medical Center) Dr. Hays has nothing to disclose.
Ghazala Perven, MD (UT Southwestern Medical Center) Dr. Perven has nothing to disclose.
No disclosure on file
Rodrigo Zepeda, MD (University of Texas Southwestern) The institution of Dr. Zepeda has received research support from NIH.
Alexander Doyle, MD (University of Texas SW Medical School) Dr. Doyle has nothing to disclose.