Abstracts

Rationale: Several studies have demonstrated that patients are poor at correctly counting seizures. These studies have focused on seizure number, but have not commented on seizure type. We aimed to determine their accuracy in assessing seizure type. Methods: Inpatients over 18 y/o admitted for video electroencephalogram (VEEG) monitoring were given a structured interview (the DISCOVER form) to determine their seizure types. Based on description, seizures were classified and given a letter. Patients were asked to keep a seizure diary using the predetermined letters to indicate seizure types. Patients admitted for differential diagnosis or with symptomatic generalized epilepsy were excluded. Results: 24 patients at our center were recruited and met inclusion criteria. 16 provided seizure diary data before discharge. Seizure syndrome was focal (14) or genetic generalized (2). 12 patients (75%) had events while keeping the diary. For those with events, in 3 (25%), all events/seizure types correlated with VEEG, although 2 had events they did not capture on their diary but were called "Non-epileptic" on VEEG report. 4 (33%) had discrepancy on focal aware (SPS) seizures only (lack of VEEG correlate for some or all reported events). 2 (17%) reported "aura(s)" (EEG negative) to staff but did not report on diary. 2 (17%) had one or more unreported focal with altered awareness (CPS). 1 (8%) had a focal with altered awareness (CPS) but reported a GTCC on their diary. Conclusions: This study confirmed patients' difficulty with seizure counting, but also suggests that patients do not always know what kind of seizure has occurred. These results illustrate a need for a better means of capturing patient reported seizure activity than traditional diary keeping. Funding: NYU Langone Medical Center Department of Neurology