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Classification of partial seizure symptoms in genetic studies of the epilepsies

From the Department of Neurology (H.C., M.R.W., T.A.P., W.A.H., R.O.), Columbia Genome Center (S.K.), Gertrude H. Sergievsky Center (M.R.W., W.A.H., R.O.), Department of Epidemiology, Mailman School of Public Health (W.A.H., R.O.), Columbia University, New York; and Epidemiology of Brain Disorders Department (R.O.), New York State Psychiatric Institute, New York.

Address correspondence and reprint requests to Dr. Ruth Ottman, G.H. Sergievsky Center, Columbia University, 630 W. 168th Street, P&S Box 16, New York, NY 10032; e-mail: ro6{at}columbia.edu

Objectives: To develop standardized definitions for classification of partial seizure symptoms for use in genetic research on the epilepsies, and evaluate inter-rater reliability of classifications based on these definitions.

Methods: The authors developed the Partial Seizure Symptom Definitions (PSSD), which include standardized definitions of 41 partial seizure symptoms within the sensory, autonomic, aphasic, psychic, and motor categories. Based on these definitions, two epileptologists independently classified partial seizures in 75 individuals from 34 families selected because one person had ictal auditory symptoms or aphasia. The data used for classification consisted of standardized diagnostic interviews with subjects and family informants, and medical records obtained from treating neurologists. Agreement was assessed by kappa.

Results: Agreement between the two neurologists using the PSSD was "substantial" or "almost perfect" for most symptom categories.

Conclusions: Use of standardized definitions for classification of partial seizure symptoms such as those in the Partial Seizure Symptom Definitions should improve reliability and accuracy in future genetic studies of the epilepsies.

Editorial, see page 1622

Supported by NIH grants R01 NS36319 and R01 NS43472 (to R.O.), and K23 NS02211 and K02 NS050429 (to M.R.W.).

Disclosure: The authors report no conflicts of interest.

Received August 1, 2005. Accepted in final form February 21, 2006.

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