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Epilepsy and Seizures: Overview

Epilepsy and Seizures: Overview

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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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

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Unsatisfactory Accuracy and Inconsistent Inter-Rater Reliability Among Electroencephalographers in Identifying

Wen Wang^1,2, Lin Wan^1,2, Jian Chen^1,2

¹Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, China.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society

|December 23, 2025

Summary

This summary is machine-generated.

Experienced electroencephalographers struggle to consistently identify subtle epileptic spasms (ES), even with detailed EEG review. Inter-rater reliability for ES detection was found to be only moderate, highlighting diagnostic challenges.

Keywords:

Accuracy Electroencephalographer Epileptic spasm Inter-rater reliability

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A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

Published on: November 13, 2016

Area of Science:

Neurology
Clinical Neurophysiology

Background:

Epileptic spasms (ES) are a critical diagnosis in epilepsy.
Accurate identification of ES is often assumed but requires verification, especially for subtle presentations like facial movements.

Purpose of the Study:

To evaluate the accuracy and inter-rater reliability of experienced electroencephalographers in identifying epileptic spasms (ES) from EEG data.
To assess the consistency of ES diagnosis among specialists.

Main Methods:

Six senior electroencephalographers reviewed EEG data from 22 patients diagnosed with ES.
Evaluators judged the presence or absence of ES in full examinations and 4-second segments.
Inter-rater reliability (IRR) was quantified using the Fleiss kappa statistic.

Main Results:

Evaluator accuracy for identifying patients with ES ranged from 0.727 to 0.90.
Overall IRR was moderate (kappa=0.45), with lower agreement among non-tertiary centers.
IRR improved significantly for 4-second segments, showing good agreement (kappa=0.63).

Conclusions:

Significant omissions in ES identification occurred among electroencephalographers.
Inter-rater reliability for ES diagnosis was unsatisfactory, indicating diagnostic challenges.
Even experienced specialists find identifying subtle ES difficult.