Effective utilization of home-video recordings for the evaluation of paroxysmal events in pediatrics

In young children, differentiating seizures from nonepileptic "spells" by history alone can be difficult, even for the specialist. Nonepileptic spells may be psychogenic (rare in the young child) or physiologic in origin. Physiologic spells misidentified as epileptic may be treated with antiepileptic medication where none is needed. Recording spells on video provides a potentially valuable supplement to the clinical history in arriving at a correct diagnosis. In practice, however, most home-video recordings prove difficult to interpret. Simple instructions to parents on the manner in which spells should be recorded will greatly increase the usefulness of home-video recordings. A systemic analysis of precipitating factors and the evolution and resolution of the spell will very often exclude seizures. The widespread availability of home-video recordings provides the pediatrician with an opportunity to visually examine a child's spells, often avoiding unnecessary investigations and referrals and allowing the physician to more confidently offer reassurance to the parents.