A structured questionnaire predicts if convulsions are epileptic or nonepileptic

Nabil J. Azar, Nataria Pitiyanuvath, Nandakumar Bangalore Vittal, Lily Wang, Yaping Shi, Bassel W. Abou-Khalil

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective: Therapy for convulsive seizures is usually initiated on the basis of clinical assessment, without video/EEG confirmation, but a nonepileptic origin may eventually be demonstrated. This study evaluates the diagnostic value of a witness-questionnaire in distinguishing between convulsive epileptic seizures (CES) and convulsive nonepileptic seizures (CNES). Methods: We prospectively identified all adult patients admitted for video/EEG evaluation of convulsive attacks and interviewed the "best" witness using 12 questions on ictal and postictal features. Results: Video/EEG diagnosed CES in 19 and CNES in 26 patients. The predictive accuracy of the questionnaire was 84.4%. Six features were strong predictors of CNES diagnosis: ictal eye closure, presence of side-to-side movements, prolonged seizure duration, and three postictal breathing features (not loud, shallow, no snoring). Conclusion: A structured witness questionnaire distinguishes CES and CNES and will help in selecting patients for early video/EEG evaluation and rapid initiation of appropriate therapy.

Original languageEnglish (US)
Pages (from-to)462-466
Number of pages5
JournalEpilepsy and Behavior
Issue number3
StatePublished - Nov 1 2010
Externally publishedYes


  • Convulsion
  • Epilepsy monitoring
  • Epileptic seizures
  • Ictal features
  • Nonepileptic seizures
  • Postictal features
  • Predictive value
  • Questionnaire

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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