The Evaluation of The Agreements of Different Epilepsy Classifications in Seizures Recorded With Video EEG Monitoring

Objective: The main purpose of the epilepsy classifications is to guide physicians to get the correct diagnosis and subsequently select the appropriate treatment. When using the daily classifications, the diagnosis and treatment of some patients sometimes remain unsatisfying, and video EEG monitoring (VEM) is the alternatively applied diagnostic tool in such patients. In the present study, the agreement of different classifications before and after short term VEM is investigated.Methods: Three hundred ninety-one patients who had undergone VEM were enrolled in the study. Forty-five cases, whose epileptic seizures could be recorded, were classified before and after VEM according to 1981 Classification of Epileptic Seizures, 1989 Epileptic Syndrome Classification, 2010 Seizure and Electroclinical Syndrome Classifications proposed by International League Against Epilepsy (ILAE) Commission on Terminology and Classification, and Semiological Seizure Classification reported by Luders et al. in 1998.Results: The intra-observer agreements of Semiological Seizure, 1989 and 2010 Electroclinical Syndrome Classifications were found to be substantial, whereas those of 1981 and 2010 Epileptic Seizure Classifications were moderate. The initial clinical diagnosis was changed in 44.7% to 56.5% of patients where a change of treatment was needed in 36.5% of the cases.Conclusion: While the Semiological Seizure Classification appears to be more consistent than the 1981 and 2010 Seizure Classifications, the impact of short term VEM on the accurate classification is remarkable.