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Conversations with patients in the seizure clinic

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Linguistics can help in diagnosing patients who experience blackouts, according to research done by Dr Catherine Robson from the University of York.  Dr Robson presented a research seminar about some of her conversation analysis work on Tuesday 26 August at Rhodes University's Department of English Language and Linguistics.

Conversation analysis can be used to help distinguish between seizure patients who have epilepsy, and others with psychogenic non-epileptic seizures (PNES), a little-known condition that is often mistaken for epilepsy.  Dr Robson shared that misdiagnosis rates for epilepsy range from 5 to 50%, and that it takes an average of seven years before patients who were previously assumed to have epilepsy are re-diagnosed with PNES. 

Research has already shown that epilepsy patients are more likely to initiate discussion about their condition in medical interviews than PNES patients are, and that epilepsy patients find it easier to describe what happens when they have a seizure than PNES patients do.

Dr Robson looked particularly at the roles played by patients' companions and those who witness their seizures in medical interviews. She found that when companions are present in these interviews, they reduce the amount of space given to patients to talk about their own seizures.  Doctors also do much of the speaking in the interviews, leaving less opportunity for diagnosis based on the patient's speech.  Because of this, Dr Robson proposed a new approach for medical interviews of seizure patients, in which companions' and patients' talk is more carefully managed, allowing seizure patients to be diagnosed more correctly.