Cargando…
Pitfalls using smartphones videos in diagnosing functional seizures
Expert review of seizure semiology looking at video recordings independent of EEG has been found to be useful for diagnosing functional seizures. Videos recorded outside the hospital containing “spells” have similar sensitivity to EEG when quality recordings are evaluated. Recently, smartphone video...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646964/ https://www.ncbi.nlm.nih.gov/pubmed/34927041 http://dx.doi.org/10.1016/j.ebr.2021.100497 |
_version_ | 1784610527545131008 |
---|---|
author | Freund, Brin Tatum, William O. |
author_facet | Freund, Brin Tatum, William O. |
author_sort | Freund, Brin |
collection | PubMed |
description | Expert review of seizure semiology looking at video recordings independent of EEG has been found to be useful for diagnosing functional seizures. Videos recorded outside the hospital containing “spells” have similar sensitivity to EEG when quality recordings are evaluated. Recently, smartphone videos were shown to serve as an adjunct to standard history and physical examination with similar diagnostic yields when compared to diagnostic video-EEG monitoring and reviewed by experts. However, caution must be exercised when interpreting videos of paroxysmal neurological events recorded by caregivers to ensure proper video quality is maintained and recorded event is representative. In this report, we present a case of initial identification of and event falsely suggesting functional seizures in a patient with epilepsy. The smartphone video of a “seizure” was recorded by his wife using her smartphone. Despite a quality recording and a history consistent with epilepsy, the smartphone video reviewed during evaluation in the clinic suggested a functional behavior in contrast to the history that suggested epilepsy manifest as convulsions. Instead of bilateral tonic-clonic motor movements, bizarre, intermittent non-clonic wild flinging movements and vocalization were identified on the smartphone video. The discordance between the clnical history and ideo prompted inpatient video-EEG monitoring. The same nonepileptic semiology was subsequently clarified to represent a physiological nonepileptic event. The event on the smartphone was typical of his agitated post-ictal state following an electroclinical tonic-clonic seizure. With treatment the seizures became controlled with antiseizure medication in long-term follow-up. We highlight the pitfalls using patient-recorded smartphone videos in patients diagnosed with epilepsy. Understanding the utility of smartphones as an adjunct to the clinical history will help in differentiating epileptic from functional seizures. |
format | Online Article Text |
id | pubmed-8646964 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-86469642021-12-17 Pitfalls using smartphones videos in diagnosing functional seizures Freund, Brin Tatum, William O. Epilepsy Behav Rep Case Report Expert review of seizure semiology looking at video recordings independent of EEG has been found to be useful for diagnosing functional seizures. Videos recorded outside the hospital containing “spells” have similar sensitivity to EEG when quality recordings are evaluated. Recently, smartphone videos were shown to serve as an adjunct to standard history and physical examination with similar diagnostic yields when compared to diagnostic video-EEG monitoring and reviewed by experts. However, caution must be exercised when interpreting videos of paroxysmal neurological events recorded by caregivers to ensure proper video quality is maintained and recorded event is representative. In this report, we present a case of initial identification of and event falsely suggesting functional seizures in a patient with epilepsy. The smartphone video of a “seizure” was recorded by his wife using her smartphone. Despite a quality recording and a history consistent with epilepsy, the smartphone video reviewed during evaluation in the clinic suggested a functional behavior in contrast to the history that suggested epilepsy manifest as convulsions. Instead of bilateral tonic-clonic motor movements, bizarre, intermittent non-clonic wild flinging movements and vocalization were identified on the smartphone video. The discordance between the clnical history and ideo prompted inpatient video-EEG monitoring. The same nonepileptic semiology was subsequently clarified to represent a physiological nonepileptic event. The event on the smartphone was typical of his agitated post-ictal state following an electroclinical tonic-clonic seizure. With treatment the seizures became controlled with antiseizure medication in long-term follow-up. We highlight the pitfalls using patient-recorded smartphone videos in patients diagnosed with epilepsy. Understanding the utility of smartphones as an adjunct to the clinical history will help in differentiating epileptic from functional seizures. Elsevier 2021-11-08 /pmc/articles/PMC8646964/ /pubmed/34927041 http://dx.doi.org/10.1016/j.ebr.2021.100497 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Freund, Brin Tatum, William O. Pitfalls using smartphones videos in diagnosing functional seizures |
title | Pitfalls using smartphones videos in diagnosing functional seizures |
title_full | Pitfalls using smartphones videos in diagnosing functional seizures |
title_fullStr | Pitfalls using smartphones videos in diagnosing functional seizures |
title_full_unstemmed | Pitfalls using smartphones videos in diagnosing functional seizures |
title_short | Pitfalls using smartphones videos in diagnosing functional seizures |
title_sort | pitfalls using smartphones videos in diagnosing functional seizures |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646964/ https://www.ncbi.nlm.nih.gov/pubmed/34927041 http://dx.doi.org/10.1016/j.ebr.2021.100497 |
work_keys_str_mv | AT freundbrin pitfallsusingsmartphonesvideosindiagnosingfunctionalseizures AT tatumwilliamo pitfallsusingsmartphonesvideosindiagnosingfunctionalseizures |