Some patients with epilepsy can reliably predict when they are likely to have a seizure, a finding that may lead to better seizure prevention, according to a study published in the January 23, 2007, issue of Neurologyฎ, the scientific journal of the American Academy of Neurology.
"Many patients report they can identify periods of increased risk for seizure, but this has not been prospectively tested before," according to lead study author Sheryl Haut, MD, of the Montefiore Medical Center in Bronx, New York, and a member of the American Academy of Neurology.
To determine how accurate patient predictions were, researchers examined 71 patients who had at least one seizure during the past year, but not more than one per day. Patients were asked to keep a daily log in which they predicted how likely they were to experience a seizure in the coming 24 hours.
Fifty-seven patients experienced seizures during the study. Of these patients, the study found they correctly predicted about 32 percent of their seizures, and 83 percent of their seizure-free days. Seizures were twice as likely to happen in the 24 hours following a positive prediction.
Some people were much better able to predict seizures than others. "The study found a subgroup of 12 patients in which seizures were more than three times as likely following a prediction," said Haut. "While these patients were younger and had a higher seizure rate, no other factor stood out as a likely reason for their higher accuracy."
If these results are confirmed in future studies, the ability to predict seizures could have significant implications for treatment of epilepsy. "Patients who can accurately predict an increased risk of seizure might be able to take medications to pre-empt a seizure before it starts," said Haut. "Accurate prediction of a reduced risk is also important since it might provide reassurance and improve quality of life for people with epilepsy."
In addition, researchers say identifying periods of time when the probability of seizures is increased also offers patients an opportunity to institute precautionary measures.
"The study has several limitations, such as patients reporting their own predictions and seizures, but overall it is an important step towards a new direction for obtaining better seizure control and improving the lives of people with epilepsy," said Haut.
The study was supported by a grant from the National Institutes of Health.
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