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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.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
406
Arteries of the Lower Limbs01:24

Arteries of the Lower Limbs

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein01:20

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein

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Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
339
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

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Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
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Diagnostic and Statistical Manual of Mental Disorders (DSM)01:27

Diagnostic and Statistical Manual of Mental Disorders (DSM)

80
The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
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Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

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γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
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Related Experiment Video

Updated: Jul 16, 2025

Equipment Setup and Artifact Removal for Simultaneous Electroencephalogram and Functional Magnetic Resonance Imaging for Clinical Review in Epilepsy
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Implementer report: ICD-10 code F44.5 review for functional seizure disorder.

Sana F Ali1,2,3, Yarden Bornovski4, Margaret Gopaul1

  • 1Neurology, Yale School of Medicine, New Haven, Connecticut, USA.

BMJ Health & Care Informatics
|September 20, 2023
PubMed
Summary

The International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) has a low 44% positive predictive value in the VA EHR. Improvements in information systems are needed for accurate diagnostic coding.

Keywords:
BMJ Health InformaticsDecision Support Systems, ClinicalElectronic Health RecordsHealth Information SystemsHealthcare Common Procedure Coding System

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Area of Science:

  • Medical Informatics
  • Clinical Informatics
  • Health Information Systems

Background:

  • The International Classification of Diseases, 10th Edition (ICD-10) introduced code F44.5 to specifically identify functional seizure disorder (FSD).
  • Accurate diagnostic coding is crucial for patient care, research, and healthcare system management.

Purpose of the Study:

  • To evaluate the validity of the ICD-10 code F44.5 for functional seizure disorder (FSD) within the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).

Main Methods:

  • Utilized an informatics search tool and a natural language processing algorithm.
  • Conducted a comprehensive chart review to validate FSD coding accuracy.

Main Results:

  • The positive predictive value (PPV) for ICD-10 code F44.5 was determined to be 44%.
  • This indicates a significant discrepancy between coded diagnoses and actual clinical documentation for FSD.

Conclusions:

  • The current ICD-10 code F44.5 demonstrates limited validity for FSD, necessitating improvements in diagnostic coding precision.
  • Enhancements to the EHR system, including curated ICD-10 term lists and appropriate code classification under neurology and psychiatry, are recommended to improve accuracy.