Abstract

This study evaluates eyewitness reliability in recognizing focal seizures, nonconvulsive generalized seizures, and psychogenic non-epileptic seizure (PNES) using ambulatory electroencephalography (EEG) monitoring with home video. Analysis of 76 patients and 650 seizure events revealed that witnesses, often family or carers in proximity (witness in proximity [WIP]), did not appear to recognize over half of focal and generalized seizures (57.5% and 57.4%, respectively). PNES were more frequently recognized, and motor seizures were significantly more likely to be acknowledged (p = 0.0009). These findings highlight the limitations of eyewitness reports in seizure recognition and reinforce the necessity of objective monitoring tools in clinical epilepsy management.