title: Utility of a questionnaire tool (QUARAS) for localizing and lateralizing seizures in the epilepsy monitoring unit (EMU).
abstract: OBJECTIVE
  An accurate description of the seizure semiology improves the recognition of the ictal onset zone and helps in hypothesizing the possible epileptogenic zone (EZ). Semiology based on a reliable description of seizures may be as good as investigative modalities, as has been shown by numerous studies. The main objective of this study was to apply a questionnaire-tool for auras and semiology (QUARAS) in refractory epilepsy cohort and compare its yield to that of standard history-taking.
  
  
  METHODS
  A drug refractory epilepsy cohort of 139 subjects was selected, based on inclusion and exclusion criteria. All subjects underwent routine history-taking, and a structured interview with QUARAS (in Hindi language) about 3-6 months later when they were admitted for pre-surgical work-up (Video-EEG, MRI, SPECT and PET), by an epilepsy nurse. Seizures were localised and lateralised at the each step separately, in a blinded manner; concordance with the final hypothesis was checked, after the epilepsy-surgery case-conference, and statistical significance of the difference calculated.
  
  
  RESULTS
  Auras were reported in significantly more number of patients after administration of QUARAS (p<0.001); there was also higher concordance between the final hypothesis and the localization and lateralization based on QUARAS than an unstructured history (p<0.001).
  
  
  CONCLUSIONS
  Administering a structured questionnaire in the native language of patients by trained personnel leads to better localisation and lateralisation and may help arrive at a hypothesis about the EZ.
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rima M
authors.initials: RM
authors.lastname: Chaudhari
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhargavi
authors.initials: B
authors.lastname: Ramanujam
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Renjith
authors.initials: R
authors.lastname: Appukuttan
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anubha
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Yuvraj
authors.initials: Y
authors.lastname: Kunwar
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Tejaniya
authors.affiliation: Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Garg
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Madakasira Vasantha
authors.initials: MV
authors.lastname: Padma
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Madhavi
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Chandrashekhar
authors.initials: C
authors.lastname: Bal
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Deepa
authors.initials: D
authors.lastname: Dash
authors.affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sarat P
authors.initials: SP
authors.lastname: Chandra
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: mtripathiaiims@gmail.com.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
mesh_terms: D000328:Adult; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis*; D006801:Humans; D007194:India; D012640:Seizures / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Auras; Epilepsy; Lateralisation; Localisation; Semiology