Utility of Home-Made Videos in an Adult Epilepsy Clinic

Introduction:According to the ILAE, the definition of epilepsy requires the occurrence at least one epileptic seizure.Up to 20% of patients diagnosed of epilepsy are not actually epileptic.An accurate diagnosis is necessary for a satisfactory management of patients with Epilepsy.New broad access image technologies allow patients and families to record homemade videos helping neurologists in diagnosis.Method: During a two-year period in an epilepsy clinic, consecutive patients were encouraged to record their events with any available device.Instructions for good quality videos were given.Three neurologists/epileptologists watched the videos in clinical session, rated the quality of the recordings following some parameters and made a clinical diagnosis.In a second phase, previous diagnosis was revised.Results: 314 consecutive patients (relatives) were encouraged to record events.52% male.Average age: 46 years.267 patients had video recording devices available (87%) (Photo camera: 100%, cell-phone: 100%, webcam: 10%, video camera: 30%).From this group, 135 (50%) felt unable to record events.Reasons given: Low seizure frequency: 60%, seizures short duration: 80%.50 events from 22 patients recorded.Mean age: 35 years.Seizure frequency three months prior to video deposit was 3, 5 seizures/patient/month.Previous epileptic syndrome diagnosed (based on description/neuroimaging/EEG): 15 focal temporal lobe epilepsy, 4 focal frontal probably symptomatic epilepsy, 3 epileptic encephalopathy. Type of seizures recorded:Focal motor with typical automatisms: 14 seizures/11 patients.Focal motor with hyperkinetic automatisms: 9 seizures/2 patients.Asymmetrical tonic motor seizures: 4 seizures/1 patient.Focal clonic seizure: 5 seizures/1 patients.Atypical absence seizure: 6 seizures/3 patients.Non-epileptic Seizure (NES): 13 seizures/3 patients.Postural tremor: 1 patient.There was agreement in diagnosis but in one.18 patients were confirmed in their Diagnosis: Epilepsy misdiagnosis: 4. Three NES and one undetermined tremor. Conclusion:Homemade videos may be of diagnostic value in epilepsy management.Training in performing good-quality videos is necessary.Webcam long term recordings should be recommended as the best recording option.