The validity of epilepsy or seizure documentation in nursing homes

Recent studies have reported that epilepsy and seizures are common in nursing homes. Prevalence has been reported to range from 5 to 9% and antiepileptic drug (AED) use is even more common. Most of these studies have relied on various forms of nursing home records, but the validity of this source data, while assumed, has not been verified. This study evaluated the degree of agreement between the Minimum Data Set (MDS), both paper and electronic versions, and actual medical records available at the nursing home. Records of 144 residents were evaluated; agreement between paper and electronic versions of the MDS was 97.8%. Agreement between the paper version of the MDS and neurologists review of the nursing home record was 92.3%. However, the criteria for diagnosing epilepsy or seizure were not well documented. Nevertheless, the agreement among nursing home records, paper MDS and electronic MDS is great enough to allow the electronic MDS to be used as a research tool, but more investigation of the actual criteria used by nursing home physicians in diagnosing epilepsy and seizures is necessary.