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Related Concept Videos

Seizures: Classification01:13

Seizures: Classification

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
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Focal Seizures
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Dissociative Disorders01:27

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Dissociative disorders represent complex psychological conditions characterized by disruptions in consciousness, memory, identity, or perception. These disruptions cause individuals to experience a disconnection from their thoughts, emotions, and memories. The phenomenon is not merely an occasional lapse in attention but a profound alteration in mental functioning that can severely impact daily life.
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Dissociative Amnesia01:21

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Dissociative amnesia is a complex psychological condition that manifests as an inability to recall personal information, often tied to traumatic or stressful events. Unlike general amnesia, individuals with this condition retain the ability to perform routine activities and procedural tasks, such as operating a phone or navigating public transportation, yet experience profound gaps in autobiographical memory. These lapses may encompass significant life events, such as suicide attempts or...
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Dissociative Identity Disorder01:30

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Dissociative Identity Disorder (DID), previously termed multiple personality disorder, is a complex psychological condition characterized by the presence of two or more distinct identities or personality states. Each identity exhibits unique patterns of behavior, voice, and mannerisms and may possess separate memories and emotional responses. The alternating control between identities can result in memory gaps and challenges in recalling daily activities, often exacerbating the individual's...
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Objective score from initial interview identifies patients with probable dissociative seizures.

Wesley T Kerr1, Emily A Janio2, Andrea M Chau2

  • 1Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA; Department of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.

Epilepsy & Behavior : E&B
|November 16, 2020
PubMed
Summary

A new Dissociative Seizures Likelihood Score (DSLS) helps identify probable dissociative seizures (DS) early. This evidence-based tool aids in triaging patients for further diagnostic assessment, improving care for those with non-epileptic seizures.

Keywords:
Artificial intelligenceClinical decision support toolFunctional seizuresMachine learningPsychogenic nonepileptic seizures

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Area of Science:

  • Neurology
  • Clinical Diagnostics

Background:

  • Dissociative seizures (DS) are often misdiagnosed, leading to delayed or incorrect treatment.
  • Early identification of probable DS is crucial for appropriate diagnostic workup and management.

Purpose of the Study:

  • To develop and validate the Dissociative Seizures Likelihood Score (DSLS).
  • To create an evidence-based tool for identifying probable DS during the initial outpatient visit.
  • To facilitate early triage for comprehensive diagnostic assessment.

Main Methods:

  • Analysis of clinical history data from 1616 patients with video-electroencephalography (vEEG) confirmed diagnoses.
  • Comparison of five patient groups: epileptic seizures (ES), DS, physiologic nonepileptic seizure-like events (PSLE), mixed DS plus ES, and inconclusive monitoring.
  • Application of data-driven methods and recursive feature elimination (RFE) to identify diagnostic features and develop the DSLS model.

Main Results:

  • The DSLS accurately identified 77% of prospective patients with either ES or DS (sensitivity 74%, specificity 84%).
  • DSLS accuracy was comparable to neurologists' clinical impression (84%).
  • A low rate of missed DS cases (3%) was observed for both the DSLS and clinicians.

Conclusions:

  • The DSLS is a reliable, evidence-based tool for identifying probable dissociative seizures using clinical history.
  • The DSLS supports clinical decision-making and aids in identifying patients requiring further diagnostic evaluation.
  • Combining the DSLS with clinical judgment can improve the identification of patients who warrant assessment at specialized epilepsy centers.