Reliability of seizure semiology in patients with 2 seizure foci

Kevin M. Rathke, Barbara Schäuble, A. James Fessler, Elson L. So

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Design: Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Setting: Epilepsy monitoring unit of referral comprehensive epilepsy program. Patients: Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. Main Outcome Measures: The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Results: Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P=.09, Wilcoxon rank sum test). Conclusion: Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

Original languageEnglish (US)
Pages (from-to)775-778
Number of pages4
JournalArchives of Neurology
Volume68
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Seizures
Electroencephalography
Semiology
Nonparametric Statistics
Epilepsy
Outcome Assessment (Health Care)
Electroencephalogram
Medical Records
Referral and Consultation

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Rathke, K. M., Schäuble, B., Fessler, A. J., & So, E. L. (2011). Reliability of seizure semiology in patients with 2 seizure foci. Archives of Neurology, 68(6), 775-778. https://doi.org/10.1001/archneurol.2011.97

Reliability of seizure semiology in patients with 2 seizure foci. / Rathke, Kevin M.; Schäuble, Barbara; Fessler, A. James; So, Elson L.

In: Archives of Neurology, Vol. 68, No. 6, 06.2011, p. 775-778.

Research output: Contribution to journalArticle

Rathke, KM, Schäuble, B, Fessler, AJ & So, EL 2011, 'Reliability of seizure semiology in patients with 2 seizure foci', Archives of Neurology, vol. 68, no. 6, pp. 775-778. https://doi.org/10.1001/archneurol.2011.97
Rathke, Kevin M. ; Schäuble, Barbara ; Fessler, A. James ; So, Elson L. / Reliability of seizure semiology in patients with 2 seizure foci. In: Archives of Neurology. 2011 ; Vol. 68, No. 6. pp. 775-778.
@article{5326d4bf52c1446cb228c90e1f3d9188,
title = "Reliability of seizure semiology in patients with 2 seizure foci",
abstract = "Objective: To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Design: Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Setting: Epilepsy monitoring unit of referral comprehensive epilepsy program. Patients: Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. Main Outcome Measures: The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Results: Interobserver agreement was 41{\%} (κ score, 0.16). Only 30 of 51 seizures (59{\%}) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53{\%}). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P=.09, Wilcoxon rank sum test). Conclusion: Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.",
author = "Rathke, {Kevin M.} and Barbara Sch{\"a}uble and Fessler, {A. James} and So, {Elson L.}",
year = "2011",
month = "6",
doi = "10.1001/archneurol.2011.97",
language = "English (US)",
volume = "68",
pages = "775--778",
journal = "Archives of Neurology",
issn = "0003-9942",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Reliability of seizure semiology in patients with 2 seizure foci

AU - Rathke, Kevin M.

AU - Schäuble, Barbara

AU - Fessler, A. James

AU - So, Elson L.

PY - 2011/6

Y1 - 2011/6

N2 - Objective: To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Design: Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Setting: Epilepsy monitoring unit of referral comprehensive epilepsy program. Patients: Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. Main Outcome Measures: The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Results: Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P=.09, Wilcoxon rank sum test). Conclusion: Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

AB - Objective: To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Design: Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Setting: Epilepsy monitoring unit of referral comprehensive epilepsy program. Patients: Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. Main Outcome Measures: The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Results: Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P=.09, Wilcoxon rank sum test). Conclusion: Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

UR - http://www.scopus.com/inward/record.url?scp=79958698471&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958698471&partnerID=8YFLogxK

U2 - 10.1001/archneurol.2011.97

DO - 10.1001/archneurol.2011.97

M3 - Article

VL - 68

SP - 775

EP - 778

JO - Archives of Neurology

JF - Archives of Neurology

SN - 0003-9942

IS - 6

ER -