Bhargavi Ramanujam1, Deepa Dash2, Manjari Tripathi3. 1. All India Institute of Medical Sciences, New Delhi, India. Electronic address: bhargavi.ramanujam@gmail.com. 2. All India Institute of Medical Sciences, New Delhi, India. Electronic address: drddash@yahoo.com. 3. All India Institute of Medical Sciences, New Delhi, India. Electronic address: mtripathiaiims@gmail.com.
Abstract
PURPOSE: To assess the contribution home-videos made on mobile phones can make to the diagnosis of Psychogenic Nonepileptic Seizures (PNES). METHODS: Consecutive patients 10-50 years old, with episodes of altered behavior or abnormal movements, unresponsiveness, or falls, were recruited after they had obtained 'good' or 'fair' quality (quality of video scale (QOV)) home-videos of their episodes on personal mobile phones; these subjects underwent video-electroencephalography (VEEG). Diagnoses of PNES, other physiological events or epileptic seizure (ES) on home-videos (by the epilepsy fellow, step 1) and on VEEGs (by a fully trained epileptologist unaware of the home-video recording, step 2) were compared. RESULTS: We screened 783 patients, and finally analyzed 269; 155 subjects had `fair' (QOV 5-7) and 114 had 'good'(QOV 8-10) quality home-videos. Concordance between steps 1 and 2 was seen in 261 of 269 (97.2%) subjects, and no significant difference was noted between the two modalities in diagnosing PNES. Differentiation between PNES, ES and other physiological events using home-videos was correct in 49.1% subjects if 532 (all subjects asked to make home-videos) and 70.7% if 369 (subjects with 'good' or 'fair' home videos), were used as denominators. Home-videos diagnosed PNES with the sensitivity of 95.4% (95% CI: 87.2%-99.1%), specificity of 97.5% (95% CI: 94.3%-99.2%), positive and negative predictive values of 92.65% (95% CI: 84.1%-96.8%) and 98.5% (95% CI: 95.6%-99.5%) respectively. CONCLUSION: Home-videos of good quality can complement VEEG in diagnosing PNES in a cost-effective way and help initiate appropriate management.
PURPOSE: To assess the contribution home-videos made on mobile phones can make to the diagnosis of Psychogenic Nonepileptic Seizures (PNES). METHODS: Consecutive patients 10-50 years old, with episodes of altered behavior or abnormal movements, unresponsiveness, or falls, were recruited after they had obtained 'good' or 'fair' quality (quality of video scale (QOV)) home-videos of their episodes on personal mobile phones; these subjects underwent video-electroencephalography (VEEG). Diagnoses of PNES, other physiological events or epilepticseizure (ES) on home-videos (by the epilepsy fellow, step 1) and on VEEGs (by a fully trained epileptologist unaware of the home-video recording, step 2) were compared. RESULTS: We screened 783 patients, and finally analyzed 269; 155 subjects had `fair' (QOV 5-7) and 114 had 'good'(QOV 8-10) quality home-videos. Concordance between steps 1 and 2 was seen in 261 of 269 (97.2%) subjects, and no significant difference was noted between the two modalities in diagnosing PNES. Differentiation between PNES, ES and other physiological events using home-videos was correct in 49.1% subjects if 532 (all subjects asked to make home-videos) and 70.7% if 369 (subjects with 'good' or 'fair' home videos), were used as denominators. Home-videos diagnosed PNES with the sensitivity of 95.4% (95% CI: 87.2%-99.1%), specificity of 97.5% (95% CI: 94.3%-99.2%), positive and negative predictive values of 92.65% (95% CI: 84.1%-96.8%) and 98.5% (95% CI: 95.6%-99.5%) respectively. CONCLUSION: Home-videos of good quality can complement VEEG in diagnosing PNES in a cost-effective way and help initiate appropriate management.
Authors: Wesley T Kerr; Emily A Janio; Andrea M Chau; Chelsea T Braesch; Justine M Le; Jessica M Hori; Akash B Patel; Norma L Gallardo; Corinne H Allas; Amir H Karimi; Ishita Dubey; Siddhika S Sreenivasan; Janar Bauirjan; Eric S Hwang; Emily C Davis; Shannon R D'Ambrosio; Mona Al Banna; Rajarshi Mazumder; Ting Wu; Zachary A DeCant; Michael G Gibbs; Edward Chang; Xingruo Zhang; Andrew Y Cho; Nicholas J Beimer; Jerome Engel; Mark S Cohen; John M Stern Journal: Epilepsy Behav Date: 2020-11-13 Impact factor: 2.937