• K Oyieke and J M Wilmshurst.
• Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, and Neuroscience Institute, University of Cape Town, South Africa. Jo.wilmshurst@uct.ac.za.
• S. Afr. Med. J. 2022 Dec 20; 113 (1): 424842-48.

BackgroundEpilepsy is often diagnosed through clinical description, but inter-observer interpretations can be diverse and misleading.ObjectiveTo assess the utility of smartphone videos in the diagnosis of paediatric epilepsy.MethodsThe literature was reviewed for evidence to support the use of smartphone videos, inclusive of advantages, ethical practice and potential disadvantages. An existing adult-based quality of video (QOV) scoring tool was adapted for use in children. A pilot study used convenience sampling of videos from 25 patients, which were reviewed to assess the viability of the adapted QOV tool against the subsequent diagnosis for the patients with videos. The referral mechanism of the videos was reviewed for the source and consent processes followed.ResultsA total of 14 studies were identified. Methodologies varied; only three focused on videos of children, and QOV was formally scored in three. Studies found that smartphone videos of good quality assisted the differentiation of epilepsy from non-epileptic events, especially with accompanying history and with more experienced clinicians. The ethics and risks of circulation of smartphone videos were briefly considered in a minority of the reports. The pilot study found that the adapted QOV tool correlated with videos of moderate and high quality and subsequent diagnostic closure.ConclusionsData relating to the role of smartphone video of events in children is lacking, especially from low- and middle-income settings. Guidelines for caregivers to acquire good-quality videos are not part of routine practice. The ethical implications of transfer of sensitive material have not been adequately addressed for this group. Prospective multicentre studies are needed to formally assess the viability of the adapted QOV tool for paediatric videos.

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