Prateik Sinha

Lina Zhang, Tonmoy Monsoor, Mehmet Efe Lorasdagi et al.

Multimodal Large Language Models (MLLMs) have demonstrated robust capabilities in recognizing everyday human activities, yet their potential for analyzing clinically significant involuntary movements in neurological disorders remains largely unexplored. This pilot study evaluates the capability of MLLMs for automated recognition of pathological movements in seizure videos. We assessed the zero-shot performance of state-of-the-art MLLMs on 20 ILAE-defined semiological features across 90 clinical seizure recordings. MLLMs outperformed fine-tuned Convolutional Neural Network (CNN) and Vision Transformer (ViT) baseline models on 13 of 18 features without task-specific training, demonstrating particular strength in recognizing salient postural and contextual features while struggling with subtle, high-frequency movements. Feature-targeted signal enhancement (facial cropping, pose estimation, audio denoising) improved performance on 10 of 20 features. Expert evaluation showed that 94.3 percent of MLLM-generated explanations for correctly predicted cases achieved at least 60 percent faithfulness scores, aligning with epileptologist reasoning. These findings demonstrate the potential of adapting general-purpose MLLMs for specialized clinical video analysis through targeted preprocessing strategies, offering a path toward interpretable, efficient diagnostic assistance. Our code is publicly available at https://github.com/LinaZhangUCLA/PathMotionMLLM.

Lina Zhang, Tonmoy Monsoor, Peizheng Li et al.

While Multimodal Large Language Models (MLLMs) have demonstrated remarkable proficiency in general video understanding, their capacity to interpret involuntary, and spatio-temporally evolving pathologic motor behaviors such as seizure semiology remains largely untested. To address this gap, we introduce Seizure-Semiology-Suite, a clinically grounded dataset and benchmark for fine-grained, structured seizure semiology understanding. The dataset includes 438 seizure videos annotated with over 35,000 dense labels covering 20 ILAE-defined semiological features. Building on this dataset, we propose a seven-task hierarchical benchmark that systematically evaluates MLLMs from low-level visual perception to temporal sequencing, narrative report generation, and seizure diagnosis. To enable clinically meaningful evaluation of generated reports, we further introduce the Report Quality Index for Seizure Semiology (Seizure-RQI). Extensive baselines across 11 open-weight MLLMs reveal systematic weaknesses in laterality reasoning, temporal localization, symptom sequencing, and clinically faithful reporting. We show that seizure-specific fine-tuning substantially improves performance across tasks, and that a two-stage neuro-symbolic framework achieves an F1 score of 0.96 on epileptic versus non-epileptic seizure classification. Seizure-Semiology-Suite establishes a rigorous benchmark for evaluating multimodal models in safety-critical medical video understanding and guides the development of clinically reliable, domain-adaptive multimodal intelligence.