Validation of a predictive calculator to distinguish between patients presenting with dissociative versus epileptic seizures, Lenio et al, 2021

Andy

Andy

Retired committee member
Dissociative seizures (also known as psychogenic nonepileptic seizures) are a common functional neurological disorder that can be difficult to distinguish from epileptic seizures. Patients with dissociative seizures provide diagnostic challenges, leading to delays in care, inappropriate care, and significant healthcare utilization and associated costs. The dissociative seizure likelihood score (DSLS) was developed by Kerr and colleagues at UCLA to distinguish between patients with epileptic seizures and dissociative seizures based on clinical and medication history as well as features of seizure semiology. We validated this calculator at the University of Colorado, which is a Level 4 National Association of Epilepsy Center. The DSLS accurately predicted the diagnosis in 81% of patients, despite local variability in the factors associated with epileptic versus dissociative seizures between the two populations. The DSLS can be a useful tool to assist with history taking and may have important utility for clinical decision making with these difficult to distinguish patient populations.
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Paywall, https://www.epilepsybehavior.com/article/S1525-5050(21)00001-9/fulltext
 
I can't read the article, but does this not suffer from the same problem that Jonathan Edwards pointed out in the physical signs for FND.

People who believe in FND believe certain things diagnose it, when these are put into a calculator it is bound to make the same diagnosis with no benefit to having a calculator. It just gives a superficial appearance of reliability and makes it seem as if functional seizures is a valid entity.
 
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