Reliability, Validity, and Feasibility of Customizable Ictal Testing Battery (C-ITB) for Assessing Cognitive...

Ictal cognitive assessments carried out in Epilepsy Monitoring Units (EMUs) have been standardized on the Western population which is unable to capture the socioeducational differences present in the Indian population.

This study focuses on modifying and rearranging components of the International League Against Epilepsy's Ictal Testing Battery (ILAE-ITB) in a local setting at an Indian epilepsy center.

The Customizable Ictal Testing Battery (C-ITB) was modified using ILAE-ITB by enabling variable order of item administration, prioritizing items testing the suspect seizure onset region. The consenting participants were assessed using both batteries. The diagnostic performance and localization ability of C-ITB were also measured.

116 patients with drug-resistant epilepsy were recruited. Association between both batteries was statistically significant using the Chi-square/Fisher's exact test (P value < 0.001). The Cohen's kappa was 85.6 and the sensitivity and specificity indices were 100% and 80% respectively. C-ITB demonstrated an inherent validity of 94.8%. There was a significant association between the localization demonstrated by C-ITB and vEEG, MRI. The localization capabilities of C-ITB and ILAE-ITB were comparable.

C-ITB is a comprehensive measure of ictal functioning adapted according to the requirements of Indian patients with epilepsy and might facilitate further research into the domain of ictal response deficits.