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Predicting epileptic seizures

WILL you have a seizure in the next 24 hours? People with epilepsy answered that question every day over the course of a year-long study, which found that some were able to anticipate when a seizure would strike.

Anecdotal evidence has suggested the possibility, but this is the first prospective study to address the question. Sheryl Haut, a neurologist at Montefiore Medical Center in New York City and lead author, believes the results could lead to better precautionary measures for patients and perhaps seizure prevention.

In the study, published in January in the journal Neurology, 71 subjects kept a daily diary, and every evening noted whether they believed a seizure would occur by the end of the next day. They also recorded the time and characteristics of any actual seizures.

The 57 subjects who had seizures throughout the study accurately predicted 32% of them; seizures were twice as likely to occur within the 24 hours after a positive prediction. Though not tracked in this study, "premonitory features" that epileptics often cite as red flags include drowsiness, headache, irritability, and depression.

Participants also predicted their seizure- free days 83% of the time. The ability to anticipate the days when a seizure will not occur may be as important as knowing when they will, says Steve Schacter, a professor of neurology at Harvard Medical School (Cambridge, Massachusetts).

Unpredictability and living in fear of the next seizure is probably the single biggest factor that impedes their quality of life, he says. "Any way to reduce that unpredictability would have substantial benefit to patients."

The next steps, he believes, will involve figuring out the physiological aspects of seizures, with the goal of stopping them before they start.

Meantime, says Haut, epileptics may be able to enhance their sense of control by paying close attention to the specifics of their own experience. Keep a diary, she advises, and get to know your own seizure triggers.

     
     

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