Home videos of patients undergoing seizures, captured using mobiles, may help in proper diagnosis and treatment of epilepsy and curb errors that may creep in when doctors rely only on the medical history of patients narrated by family members.
The study was conducted on 340 patients by a team of neurologists from AIIMS. The family members of 312 patients brought home videos of seizures to the doctors for an analysis. While the videos were expected to yield information about the seizures, the doctors quizzed caregivers of persons with epilepsy, who were waiting for admission to the Epilepsy Monitoring Unit (EMU), on a set of 29 physical manifestations of seizures- rhythmic jerky movements of hands or legs, movements or turns of the head or the eyes, the duration of the episode, any abnormal twisting or tightening of limbs. The results were then compared to the findings from video electroencophalography (VEEG). The study found that the results were almost as accurate as reports of VEEG.
‘Epilepsy can be appropriately diagnosed and treated using videos recorded from home using smarphones. These videos hold more credibility than the caregiver's opinion.’
In the study involving 340 patients having mean age of 26.76 +7.5 years, doctors said parents were the most common caregivers (82%), followed by siblings (6.8%) and spouses (4.4%). The majority of the caregivers had only primary school education (36.2%), followed by significant proportions who were uneducated (28.8%). Only 22.3% had secondary school education and 12.6% were graduates or post-graduates.
Manjari Tripathi, professor in the Department of Neurology at AIIMS said "We found that home videos were more helpful in identifying epilepsy type than description of medical history by the caregivers." She added " Even in AIIMS when patients come and there is an epileptic attack, they try to put a shoe, spoon or onion. They don't know about the right first-aid. We suggest that while first aid must be done but, if possible, caregivers should also record the physical changes or symptoms. This is because treatment of epilepsy is based only on clinical symptoms and not diagnostic findings alone."
The findings of the study have been published in the latest issue of Epilepsy Research
an international medical journal. Researchers have pointed out that caregiver's description of epileptic attack could be flawed due to factors such as anxiety, distress, alarm and confusion during the attack. While epilepsy has the symptoms of unprovoked seizures triggered by short lasting electrical discharges in the brain, doctors say the precise set of symptoms experienced by patients is important to classify the epilepsy into one of two types - focal or generalized epilepsy, for which treatments are different.
Experts say there are about 6- 10 million people with epilepsy in India and many of them don't receive appropriate treatment.