Evaluation of the accuracy of seizure descriptions by the relatives of patients with epilepsy

The descriptions of seizures by witnesses: are important in the diagnosis a nd classification of epileptic seizures. The aim of the study was to evalua te the accuracy of this information obtained from relatives of patients wit h epileptic and non-epileptic attacks. Thirty patients with epileptic or no n-epileptic attacks had seizures videorecorded whilst inpatients at the Ass essment and Treatment Centre of the National Society for Epilepsy and the N ational Hospital for Neurology and Neurosurgery, Chalfont, Buckinghamshire, UK. A relative or close friend of each patient viewed the recording and su bsequently completed a structured questionnaire, testing recall of 15 separ ate elements of the episode. This account was compared to a definitive eval uation completed by medical staff. An accuracy of describing seizures was t herefore obtained. Our results showed that there was a wide variation in th e accuracy of recall with convulsive episodes described less well than non- convulsive (median accuracies 414.5 and 70%, respectively, P < 0.05). Attac ks in which the diagnosis had been changed, following admission, from the o ne obtained on history alone were particularly inaccurately described (medi an accuracy 26%). Elements of the questionnaire that were most inaccurately recalled were description of limb movement and post-ictal behaviour. Those most accurately described were facial appearance and vocalization. Feature s only present in non-epileptic attacks included reactivity to eyelash stim ulation, opisthotonic posturing, flailing or protective limb movements. In conclusion, our results confirm that inaccuracy exists when witnesses descr ibe attacks and that this may lead to errors in diagnosis and subsequent tr eatment. (C) 2001 Elsevier Science B.V. All rights reserved.