Abstracts

Rationale: Seizures can create impaired consciousness which have a major negative impact on patient quality of life. This causes injury, cognitive lapses, and social stigma. Retrospective video/EEG and behavior analysis has been done to evaluate impaired consciousness in epilepsy in prior studies. Yet, due to lack of a standardized or validated behavioral testing battery for evaluating impaired consciousness during epileptic seizures, minimal work has been done to measure unconsciousness during seizures directly. To address this issue, we created and tested a standardized evaluation battery, the Responsiveness in Epilepsy Scale (RES). This assesses responsiveness during epileptic seizures and is designed for use in patients during continuous video/EEG monitoring. This battery tests various sensory, motor, and memory functions during and following seizures. Methods: Initial reliability testing involved evaluating 10 normal subjects with 2 simulated seizures each (one simple partial and one complex partial). This was repeated separately with 2 examiners (40 seizures total). 2 readers analyzed these simulated seizures and behavioral testing separately on video tape. Examiners and readers were blinded to seizure type. Results: Our results show 100% agreement between the two readers for seizure classification as simple partial vs. complex partial based on items performed on the RES. The agreement between both different examiners and different readers was 94% when analyzing scores for individual test items during simple partial seizures. The agreement between different examiners was 84%, and between different readers was 94% for individual test items with complex partial seizures. Conclusions: The test-retest and interrater reliability of our proposed RES are in the acceptable range based on there results. Furthermore, our results show the feasibility of this proposed method for prospectively evaluating impaired consciousness during seizures. Future investigation will include evaluating spontaneous seizures using the RES with epileptic patients under continuous video/EEG monitoring.