Can IGE be differentiated from focal epilepsy based on clinical characteristics?

Background and Rationale: Differentiating idiopathic generalized epilepsy (IGE) from focal epilepsy (FE) can be challenging, particularly when clinical descriptions are incomplete or atypical. Identifying combinations of readily available clinical characteristics that distinguish these epilepsy types may improve diagnostic accuracy and guide appropriate investigations and treatment. Research Question: Can IGE be differentiated from focal epilepsy based on clinical characteristics? Methods: This will be a retrospective observational study of consecutive patients with IGE or FE attending the outpatient epilepsy clinic. Patients with an established diagnosis based on clinical, EEG and/or imaging findings will be included. Demographic and clinical characteristics will be extracted from medical records, including age at seizure onset, sex, seizure types, nocturnal seizures, family history of epilepsy, seizure triggers, history of febrile seizures, developmental history, and other relevant clinical features. Variables associated with IGE versus FE will initially be examined using univariable analyses, followed by multivariable logistic regression to identify independent predictors. Prediction Model: A clinical prediction model will be developed using independently associated variables. Regression coefficients will be used to derive a weighted prediction score estimating the probability of IGE. Model performance will be assessed using discrimination (area under the receiver operating characteristic curve), sensitivity, specificity, positive and negative predictive values, and calibration.