Optimizing the patient’s history: a modern approach to age-old life interviews

Medical history taking is the starting point of the diagnostic process and still maintains its leading role today, despite the current development of laboratory tests and neuroimaging techniques. Subjects with photosensitivity have high susceptibility for an epilep-tic seizure provoked by visual stimuli and require a specific ap-proach in gathering information, especially to ascertain the occur-rence of reflex seizures and to identify triggering factors. This chapter addresses the way to ascertain: a) the presence of reflex sei-zures induced by visual stimuli; b) the triggering factors and envi-ronmental risk; c) signs and symptoms to be investigated on the ba-sis of the patient's age and the main syndromes where photosensitiv-ity is involved; d) the occurrence of self-induced seizures with their psychosocial aspects. In these patients the medical history should be based on a multimodal approach: a) face-to-face interviews with the patient and/or parents in the case of children; b) specific question-naire on environmental context and living habits; c) to require col-laborative patients to take photographs of stimuli they consider trig-gering, and d) to ask them to draw the visual symptoms occurring during seizures. Since the anamnesis should be conducted with a specific approach and targeted questions, it would be advisable to develop professional training courses on how to collect the medical history in epileptic patients with photosensitivity. Medical history taking is the starting point of the diagnostic process and still maintains its leading role today, despite the current development of laboratory tests and neuroimaging techniques. Subjects with photosensitivity have high susceptibility for an epilep-tic seizure provoked by visual stimuli and require a specific ap-proach in gathering information, especially to ascertain the occur-rence of reflex seizures and to identify triggering factors. This chapter addresses the way to ascertain: a) the presence of reflex sei-zures induced by visual stimuli; b) the triggering factors and envi-ronmental risk; c) signs and symptoms to be investigated on the ba-sis of the patient's age and the main syndromes where photosensitiv-ity is involved; d) the occurrence of self-induced seizures with their psychosocial aspects. In these patients the medical history should be based on a multimodal approach: a) face-to-face interviews with the patient and/or parents in the case of children; b) specific question-naire on environmental context and living habits; c) to require col-laborative patients to take photographs of stimuli they consider trig-gering, and d) to ask them to draw the visual symptoms occurring during seizures. Since the anamnesis should be conducted with a specific approach and targeted questions, it would be advisable to develop professional training courses on how to collect the medical history in epileptic patients with photosensitivity.