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If seizures left speechless: CA-P-S C-A-R-E, a proposal of a new ictal language evaluation protocol
- Source :
- Neurological Sciences
- Publication Year :
- 2020
-
Abstract
- Introduction We aimed to create standardized protocol for language examination in patients who underwent video-EEG recording and assessed its efficacy in the characterization of ictal language impairment, its ability to differentiate this from impaired awareness, and interobserver reliability in clinical practice. Methods From our database of video-EEG recordings, we selected a representative sample of 63 focal seizures with presumed language impairment. A multidisciplinary team of epileptologists, EEG technicians, and speech therapists analyzed the selected videos to highlight the critical issues of ordinary ictal language evaluation. We subsequently followed a multi-step process to develop the protocol and assess its interobserver reliability. Results A protocol based on seven tests in hierarchical succession was created, summed up in the acronym CA-P-S C-A-R-E (Closed Answers, Pro-speak question, Simple orders, Common object denomination, Audio repetition, Reading, Evoke). Following its preliminary administration for 5 months, we assessed the inter-observer reliability of 16 healthcare professionals in distinguishing between language impairment and impaired awareness among a sample of 10 seizures, finding a substantial agreement (kappa 0.61). Conclusion The proposed protocol, made of simple and easy to memorize tests, is an effective tool that evaluates multiple domains beyond language. Its use could help to recognize ictal aphasia effectively and differentiate it from impaired awareness, minimizing inter-examiner variability.
- Subjects :
- medicine.medical_specialty
media_common.quotation_subject
Video Recording
Dermatology
Audiology
Electroencephalography
Standardized language protocol
050105 experimental psychology
Memorization
03 medical and health sciences
Epilepsy
0302 clinical medicine
Ictal testing
Seizures
Aphasia
Reading (process)
medicine
Humans
0501 psychology and cognitive sciences
Ictal
Acronym
media_common
Protocol (science)
medicine.diagnostic_test
05 social sciences
Reproducibility of Results
General Medicine
medicine.disease
Psychiatry and Mental health
Ictal aphasia
Original Article
Neurology (clinical)
medicine.symptom
Psychology
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15903478
- Volume :
- 42
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
- Accession number :
- edsair.doi.dedup.....5f8e0ca6ce857abb988cbae6b6bc9f26