Seizure severity in children with epilepsy: a parent-completed scale compared with clinical data.
OBJECTIVE
We wished to compare a parent-completed scale quantifying seizure severity (SS) in children with various seizure types with the clinicians' impression of SS and other clinical data.


METHODS
The parents of 117 children with recurrent seizures completed a 13-item, subjective scale (The Hague Seizure Severity Scale, HASS). Eight treating neurologists quantified SS on a 10-point Visual Analog Scale (VAS) and supplied other clinical data.


RESULTS
Both the HASS and the VAS assessments of SS showed considerable variation within one seizure type. Significant differences were noted between groups with (a) absences and simple partial seizures (SPS), (b) complex partial seizures (CPS), and (c) generalized tonic-clonic seizures (GTCS). The correlation coefficient between the neurologists' and the parents' scores was 0.45 but did not exceed 0.26 after stratification for seizure type. The parents' score was not substantially influenced by various other clinical variables. The neurologists' score was correlated with resistance to treatment and presence of mental retardation.


CONCLUSIONS
The SS ratings of the parents and the neurologists were not substantially correlated. The consideration that parents, as eyewitnesses to the seizures, are probably better judges of SS than clinicians may favor the use of a parent-completed scale to quantify SS. The HASS is a valid and reliable measure of parent-perceived SS that can be useful as an outcome measure in childhood epilepsy.
Carpay
J A
JA
Department of Child Neurology, Westeinde Hospital, The Hague, The Netherlands.
Vermuelen
J
J
Stroink
H
H
Brouwer
O F
OF
Peters
A C
AC
Aldenkamp
A P
AP
van Donselaar
C A
CA
Arts
W F
WF
D000367:Age Factors; D002648:Child; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009462:Neurology; D017063:Outcome Assessment, Health Care; D010290:Parents; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index