1. Accuracy of seizure diagnosis based on smartphone seizure semiology anaysis
2. Assess the factors that affect the diagnostic reliability of smartphone videos

E pilepsy has a substantial global burden of disease.1 Diagnosis is made clinically based on a historical recount of witnessed events and a laboratory assessment. Differential diagnosis for seizures is broad. Even seasoned clinicians can be misled when individuals lack medical knowledge or pertinent terminology to accurately represent witnessed seizure behavior.2Video electroencephalogram (EEG) monitoring (VEM) is recommended when there is diagnostic uncertainty in classifying seizure type or epilepsy syndrome.3 Video EEG monitoring provides objective evidence for definitive diagnosis4 ;Additionally, VEM may not be practical for some patients because of relative infrequency of events Geographic limitations, transportation constraints, and insurance coverage may also restrict access.2,4 While VEM is the criterion standard for seizure diagnosis, web-based smartphone use has become a popular means to augment clinical practice involving seizure reporting by people with epilepsy. However, smartphone videos are not recorded in a controlled environment in which the clinicians themselves are able to define when and how each spell is to be recorded,. As such, there are issues of focus, lighting, duration, and initiation that must be considered when interpreting homemade smartphone video recordings obtained by a lay population of caregivers to evaluate people with seizures on the other hand, it has been proven that discriminating seizure's semiology is a learned skill and requires specific neurologic training 11We hypothesize that outpatient smartphone videos predictive value in patients referred for evaluation of epilepsy is variable and depends on multiple factors such as seizure semiology, and interpreting physician . on the other hand, there is no consensus on quality standards and safety recommendation of smartphone videos.

Inclusion Criteria:

1. Patients were included in the study at any age
2. provided voluntary consent, completed an HP,
3. submitted an outpatient smartphone video of their primary ictal event, underwent inpatient VEM,

Exclusion Criteria:

1. Patients were exclude, pregnant women
2. had an incomplete/absent HP, had no smartphone video,
3. did not undergo VEM, had a confirmed history of mixed epileptic and nonepileptic events (based on prior VEM), declined study participation, or did not provide informed consent

prospective study evaluated adult outpatient smartphone videos Study participants were outpatients referred with events that could have or could not have been epileptic seizures for elective evaluation. We prospectively collected consecutive patients who presented for evaluation of seizure-like episodes Patients who were included were those who had an interpretable smartphone video of the event in question and who eventually completed EEG-video monitoring . All patients included in the final analysis signed a consent form upon admission to the video-EEG that included an agreement statement. smartphone Videos were reviewed by general neurologist and epileptogist each separately The smartphone diagnosis was then compared to the eventual diagnosis based on the gold standard video-EEG monitoring. Each interpretation will be done blinded