Seizure severity assessment tools for adult epilepsy patients: A systematic review

Rose Aniza Rusli; Mohd Makmor Bakry; Noraida Mohamed Shah; Tan Hui Jan

doi:10.1016/j.yebeh.2023.109154

Seizure severity assessment tools for adult epilepsy patients: A systematic review

Epilepsy Behav. 2023 May:142:109154. doi: 10.1016/j.yebeh.2023.109154. Epub 2023 Mar 29.

Authors

Rose Aniza Rusli¹, Mohd Makmor Bakry², Noraida Mohamed Shah³, Tan Hui Jan⁴

Affiliations

¹ Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia; Hospital Shah Alam, Persiaran Kayangan, 40000 Shah Alam, Selangor, Malaysia.
² Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. Electronic address: mohdclinpharm@ukm.edu.my.
³ Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
⁴ Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia.

PMID: 37001468
DOI: 10.1016/j.yebeh.2023.109154

Abstract

Introduction: Seizure outcomes from antiseizure medication (ASM) therapy can be measured across various domains using assessment tools. The available tools may contain an array of different components or items. Seizure severity assessment, as opposed to seizure frequency count may have been a more accurate measurement in determining the effectiveness of ASM therapy. This study aimed to review studies developing seizure severity assessment tools for adults with epilepsy, describe the development methods and validation, and compare the list of items in these tools.

Methods: The systematic search utilized established databases such as Scopus, Ovid, Web of Science, Medline, Wiley Online, and Cochrane Library. Studies published from inception to December 15, 2022, were selected. Publications describing the development of tools to measure seizure severity among adult epilepsy patients were included. Outcome measures including the tool's content, development methods, validity, and reliability assessments were compared.

Results: The search produced eight publications describing the development of eight seizure severity assessment tools. One of these tools is part of a multidimensional assessment of the overall impact of epilepsy. The frequently used method in the initial development was the qualitative method (n = 6) where two publications reanalyzed the items from previous studies. Face validity was the most common validation test conducted (n = 4). At least one reliability assessment was conducted for each of the tools, most commonly by the test-retest method (n = 6) and inter-rater reliability (n = 5). All of these tools cover the components of pre-ictal (warning/aura), ictal, and postictal (recovery) events.

Conclusion: The identified tools described the assessment of seizure severity using various subscales. The emergence of new methods in quantifying seizure severity unfolds opportunities in discovering more comprehensive assessments of seizure severity in both clinical trials and daily clinical practice.

Keywords: Antiseizure medication therapy; Assessment tool; Epilepsy; Seizure severity.

Publication types

Systematic Review
Review

MeSH terms

Adult
Anticonvulsants / therapeutic use
Epilepsy* / diagnosis
Epilepsy* / drug therapy
Humans
Outcome Assessment, Health Care
Reproducibility of Results
Research Design
Seizures / diagnosis
Seizures / drug therapy

Substances

Anticonvulsants