Elsevier

Epilepsy Research

Volume 8, Issue 3, April 1991, Pages 245-251
Epilepsy Research

Research report
The development of a seizure severity scale as an outcome measure in epilepsy

https://doi.org/10.1016/0920-1211(91)90071-MGet rights and content

Abstract

In controlled trials of antiepileptic drugs (AEDs) seizure frequency is often the only variable considered. With little prospect of improving assessment of AEDs, using seizure counts as the only end-point, there is a need for the development of new outcome measures.

Clinical experience indicates that seizure severity is equally important to the patient and, by preventing seizure spread, AEDs can influence seizure severity without necessarily reducing seizure frequency. A scale capable of measuring seizure severity and change of severity attributable to treatment could be a useful additional outcome measure. Such a scale should exhibit the basic properties of validity and reliability.

An easily administrable 16-point scale, containing 2 subscales — perception of control and ictal/post-ictal effects — has been developed. This scale has been tested on a patient population (n = 159) representative of that seen in trials of novel AEDs.

Using standardised statistical methods, the scale has been shown to be both reliable and valid.

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    However, relatively low internal consistencies are rather common in brief measures that aim to measure the broad Big Five dimensions (Boele et al., 2017; Denissen et al., 2008b). The Liverpool Seizure Severity Scale (LSSS) was used to assess seizure frequency and severity in the patient sample (Baker et al., 1991; Cramer and French, 2001). Seizure frequency was assessed using a single item, whereas seizure severity was measured by the LSSS 2.0 scaled summary score (Scott-Lennox et al., 2001).

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