CLASSIFICATION OF COMPLEX FEATURES OF FEBRILE SEIZURES - INTERRATER AGREEMENT

As part of a prospective study of febrile seizures, three independent pediatric neurologists rated each of 100 febrile seizures for the presence of complex features: focality, long duration (greater-than-or-equal-to 10 min), and occurrence of multiple seizures. Seizure descriptions were assembled from all information available in the medical record and from a semistructured interview of a person who had witnessed the seizure. Interrater agreement assessed by kappa indicated excellent agreement with regard to whether the seizures were multiple or prolonged (kappa greater-than-or-equal-to 0.85) and fair to good agreement with regard to focality (kappa = 0.61-0.78). Disagreement occurred most often regarding assessment of focality. Reasons for disagreement included variation in interpretation of lateral eye deviation, staring episodes, and motor asymmetries in the context of a bilateral convulsion.