The utility of mobile telephone-recorded videos as adjuncts to the diagnosis of seizures and paroxysmal events in children with suspected epileptic seizures
DOI:
https://doi.org/10.7196/SAMJ.2023.v113i1.16661Keywords:
Epilepsy, Caregiver, peadiatricAbstract
Background. Epilepsy is often diagnosed through clinical description, but inter-observer interpretations can be diverse and misleading.
Objective. To assess the utility of smartphone videos in the diagnosis of paediatric epilepsy.
Methods. The literature was reviewed for evidence to support the use of smartphone videos, inclusive of advantages, ethical practice
and potential disadvantages. An existing adult-based quality of video (QOV) scoring tool was adapted for use in children. A pilot study
used convenience sampling of videos from 25 patients, which were reviewed to assess the viability of the adapted QOV tool against
the subsequent diagnosis for the patients with videos. The referral mechanism of the videos was reviewed for the source and consent
processes followed.
Results. A total of 14 studies were identified. Methodologies varied; only three focused on videos of children, and QOV was formally scored in three. Studies found that smartphone videos of good quality assisted the differentiation of epilepsy from non-epileptic events, especially with accompanying history and with more experienced clinicians. The ethics and risks of circulation of smartphone videos were briefly considered in a minority of the reports. The pilot study found that the adapted QOV tool correlated with videos of moderate and high quality and subsequent diagnostic closure.
Conclusions. Data relating to the role of smartphone video of events in children is lacking, especially from low- and middle-income
settings. Guidelines for caregivers to acquire good-quality videos are not part of routine practice. The ethical implications of transfer of
sensitive material have not been adequately addressed for this group. Prospective multicentre studies are needed to formally assess the viability of the adapted QOV tool for paediatric videos.
References
Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia 2014;55(4):475-482. https://doi.org/10.1111/epi.12550
SchefferIE,BerkovicS,CapovillaG,etal.ILAEclassificationoftheepilepsies:PositionpaperoftheILAE Commission for Classification and Terminology. Epilepsia 2017;58(4):512-521. https://doi.org/10.1111/ epi.13709
Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994;35(Suppl 2):S1-S6.
Smith D, Defalla BA, Chadwick DW. The misdiagnosis of epilepsy and the management of refractory epilepsy in a specialist clinic. QJM 1999;92(1):15-23. https://doi.org/10.1093/qjmed/92.1.15
HindleyD,AliA,RobsonC.Diagnosesmadeinasecondarycare‘fits,faints,andfunnyturns’clinic.Arch Dis Child 2006;91(3):214-218. https://doi.org/10.1136/adc.2004.062455
Scheepers B, Clough P, Pickles C. The misdiagnosis of epilepsy: Findings of a population study. Seizure 1998;7(5):403-406. https://doi/10.1016/s1059-1311(05)80010-x
OtoMM.Themisdiagnosisofepilepsy:Appraisingrisksandmanaginguncertainty.Seizure2017;44:143- 146. https://doi.org/10.1016/j.seizure.2016.11.029
Gastaut HJ, Bert J. EEG changes during cinematographic presentation; moving picture activation of the EEG. Electroencephalogr Clin Neurophysiol 1954;6(3):433-444. https://doi.org/10.1016/0013- 4694(54)90058-9
Velis D, Plouin P, Gotman J, et al. Recommendations regarding the requirements and applications for long-term recordings in epilepsy. Epilepsia 2007;48(2):379-384. https://doi.org/10.1111/j.1528- 1167.2007.00920.x
Hingray C, El-Hage W, Duncan R, et al. Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force. Epilepsia 2018;59(1):203- 214. 2017/11/20. https://doi.org/10.1111/epi.13952
Wirrell EC, Grinspan ZM, Knupp KG, et al. Care delivery for children with epilepsy during the COVID-19 pandemic: An international survey of clinicians. J Child Neurol 2020;35(13):924-933. https:// doi.org/10.1177/0883073820940189
Ojeda J, Gutierrez G, Del Rio Villegas R, et al. Utility of home-made videos in an adult epilepsy clinic. J Neurol Dis 2016;4(7):311. https://doi.org/10.4172/2329-6895.1000311
Dash D, Sharma A, Yuvraj K, et al. Can home video facilitate diagnosis of epilepsy type in a developing country? Epilepsy Res 2016;125:19-23. https://doi.org/10.1016/j.eplepsyres.2016.04.004
Huang LL, Wang YY, Liu LY, et al. Home videos as a cost-effective tool for the diagnosis of paroxysmal events in infants: Prospective study. JMIR Mhealth Uhealth 2019;7(9):e11229. https://doi. org/10.2196/11229
Amin U, Primiani CT, MacIver S, et al. Value of smartphone videos for diagnosis of seizures: Everyone owns half an epilepsy monitoring unit. Epilepsia 2021;62(9):e135-e139. https://doi.org/10.1111/epi.17001 16. Tatum WO, Hirsch LJ, Gelfand MA, et al. Video quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study. Eur J Neurol 2021;28(5):1453-1462. https://doi.
org/10.1111/ene.14744.
Tatum WO, Hirsch LJ, Gelfand MA, et al. Assessment of the predictive value of outpatient smartphone videos for diagnosis of epileptic seizures. JAMA Neurol 2020;77(5):593-600.https://doi.org/10.1001/ jamaneurol.2019.4785
Ramanujam B, Dash D, Tripathi M. Can home videos made on smartphones complement video-EEG in diagnosing psychogenic nonepileptic seizures? Seizure 2018;62:95-98. https://doi.org/10.1016/j. seizure.2018.10.003.
Karakas C, Modiano Y, Van Ness PC, et al. Home video prediction of epileptic vs. nonepileptic seizures in US veterans. Epilepsy Behav 2021;117:107811. https://doi.org/10.1016/j.yebeh.2021.107811
Chen DK, Graber KD, Anderson CT, et al. Sensitivity and specificity of video alone versus electroencephalography alone for the diagnosis of partial seizures. Epilepsy Behav 2008;13(1):115-118. https://doi.org/10.1016/j.yebeh.2008.02.018
Erba G, Giussani G, Juersivich A, et al. The semiology of psychogenic nonepileptic seizures revisited: Can video alone predict the diagnosis? Preliminary data from a prospective feasibility study. Epilepsia 2016;57(5):777-785. https://doi.org/10.1111/epi.13351
Beniczky SA, Fogarasi A, Neufeld M, et al. Seizure semiology inferred from clinical descriptions and from video recordings. How accurate are they? Epilepsy Behav 2012;24(2):213-215. https://doi. org/10.1016/j.yebeh.2012.03.036
Goodwin E, Kandler RH, Alix JJ. The value of home video with ambulatory EEG: A prospective service review. Seizure 2014;23(6):480-482. https://doi.org/10.1016/j.seizure.2014.02.008.
Samuel M, Duncan JS. Use of the hand held video camcorder in the evaluation of seizures. J Neurol Neurosurg Psychiatr 1994;57(11):1417-1418. https://doi.org/10.1136/jnnp.57.11.1417
Wasserman D, Herskovitz M. Epileptic vs psychogenic nonepileptic seizures: A video-based survey. Epilepsy Behav 2017;73:42-45. https://doi.org/10.1016/j.yebeh.2017.04.020
Meinardi H, Scott RA, Reis R, et al. The treatment gap in epilepsy: The current situation and ways forward. Epilepsia 2001;42(1):136-149.
Ngugi AK, Bottomley C, Kleinschmidt I, et al. Estimation of the burden of active and life-time epilepsy: A meta-analytic approach. Epilepsia 2010;51(5):883-890. https://doi.org/10.1111/j.1528- 1167.2009.02481.x
Brodie MJ, Barry SJ, Bamagous GA, et al. Patterns of treatment response in newly diagnosed epilepsy. Neurology 2012;78(20):1548-1554. https://doi.org/10.1212/WNL.0b013e3182563b19
Mannan JB, Wieshmann UC. How accurate are witness descriptions of epileptic seizures? Seizure 2003;12(7):444-447. https://doi.org/10.1016/s1059-1311(03)00052-9
Leach JP, Lauder R, Nicolson A, et al. Epilepsy in the UK: Misdiagnosis, mistreatment, and undertreatment? The Wrexham area epilepsy project. Seizure 2005;14(7):514-520. https://doi. org/10.1016/j.seizure.2005.08.008
Uldall P, Alving J, Hansen LK, et al. The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events. Arch Dis Childhood 2006;91(3):219-221. https://doi. org/10.1136/adc.2004.064477
Elger CE, Hoppe C. Diagnostic challenges in epilepsy: Seizure under-reporting and seizure detection. Lancet Neurol 2018;17(3):279-288. https://doi.org/10.1016/S1474-4422(18)30038-3
Muayqil TA, Alanazy MH, Almalak HM, et al. Accuracy of seizure semiology obtained from first-time seizure witnesses. BMC Neurol 2018;18(1):135. https://doi.org/10.1186/s12883-018-1137-x
Heo JH, Kim DW, Lee SY, et al. Reliability of semiology description. Neurologist 2008;14(1):7-11.
https://doi.org/10.1097/NRL.0b013e3181343cb4
Benbir G, Demiray DY, Delil S, et al. Interobserver variability of seizure semiology between two neurologist and caregivers. Seizure 2013;22(7):548-552. https://doi.org/10.1016/j.seizure.2013.04.001
Rugg-Gunn FJ, Harrison NA, Duncan JS. Evaluation of the accuracy of seizure descriptions by the relatives of patients with epilepsy. Epilepsy Res 2001;43(3):193-199. https://doi.org/10.1016/s0920- 1211(00)00209-6
Van de Vel A, Cuppens K, Bonroy B, et al. Long-term home monitoring of hypermotor seizures by patient-worn accelerometers. Epilepsy Behav 2013;26(1):118-125. https://doi.org/10.1016/j. yebeh.2012.10.006
Fisher RS, Blum DE, DiVentura B, et al. Seizure diaries for clinical research and practice: Limitations and future prospects. Epilepsy Behav 2012;24(3):304-310. https://doi.org/10.1016/j.yebeh.2012.04.128 39. Williams JA, Cisse FA, Schaekermann M, et al. Smartphone EEG and remote online interpretation for
children with epilepsy in the Republic of Guinea: Quality, characteristics, and practice implications.
Seizure 2019;71:93-99. https://doi.org/10.1016/j.seizure.2019.05.025
Chapman Smith SN, Govindarajan P, Padrick MM, et al. A low-cost, tablet-based option for prehospital
neurologic assessment: The iTREAT Study. Neurology 2016;87(1):19-26. https://doi.org/10.1212/
wnl.0000000000002799
Drummond L, Brunnhuber F. ‘There’s no place like home’ – a prospective control study of home video telemetry versus inpatient video telemetry at Kings College Hospital. Abstract. Epilepsia 2009;50(Suppl 4):S125. 42. Kandler R, Ponnusamy A, Wragg C. Video ambulatory EEG: A good alternative to inpatient video
telemetry? Seizure 2017;47:66-70. https://doi.org/10.1016/j.seizure.2017.02.010
Lawley A, Evans S, Manfredonia F, et al. The role of outpatient ambulatory electroencephalography in the diagnosis and management of adults with epilepsy or nonepileptic attack disorder: A systematic
literature review. Epilepsy Behav 2015;53:26-30. https://doi.org/10.1016/j.yebeh.2015.09.032
Patel AC, Thornton RC, Mitchell TN, et al. Advances in EEG: Home video telemetry, high frequency oscillations and electrical source imaging. J Neurology 2016;263(10):2139-2144. Article. https://doi.
org/10.1007/s00415-016-8159-3
Zeiler SR, Kaplan PW. Our digital world: Camera phones and the diagnosis of a seizure. Lancet 2009;373(9681):2136. https://doi.org/10.1016/S0140-6736(09)60304-4
Jory C, Shankar R, Coker D, et al. Safe and sound? A systematic literature review of seizure detection methods for personal use. Seizure 2016;36: 4-15. https://doi.org/10.1016/j.seizure.2016.01.013
Vital Wave Consulting. mHealth for Development: The opportunity of mobile technology for healthcare in the developing world. Washington, DC: United Nations Foundation, Vodafone Foundation, 2009. http://www.globalproblems-globalsolutions-files.org/unf_website/assets/publications/technology/ mhealth/mHealth_for_Development_full.pdf (accessed 30 November 2022).
Poushter J, Bishop C, Chwe H. Social media use continues to rise in developing countries, but plateaus across developed ones. Washington, DC: Pew Research Center, 2018. https://www.pewresearch.org/ global/2018/06/19/social-media-use-continues-to-rise-in-developing-countries-but-plateaus-across- developed-ones/ (accessed 5 December 2022).
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