What evidence was missing when a case report classified events before postictal catatonia?

The clinicians had observations but no video-EEG confirmation

A case report described persistent catatonic signs after events the authors considered epileptic seizures. Staff observed one of the events, and the authors cited an increase in creatine kinase as supporting evidence. The discussion also expressly states that video-EEG was unavailable and that the event classification therefore retained uncertainty.

Later findings addressed a different question

The authors used the Bush–Francis Catatonia Rating Scale to follow the patient’s signs and described improvement during lorazepam treatment. That course informs the description of the later catatonic syndrome. It does not supply the missing simultaneous electrical recording and video of the earlier events.

Build the expert chronology from the evidence actually collected

Separate witness observations, event-time recordings, later EEG results, laboratory tests and clinical response. State which were available at each stage and which retrospective classification depends on inference. A detailed clinical course can make an explanation plausible while leaving a specific earlier event unconfirmed.

Source paper

Read the study at PubMed Central (PMC6206662).