Seizure Prediction: An Elusive, Yet Important, Goal

For people with epilepsy, the unpredictable nature of seizures causes great stress and can disrupt their lives in many ways. If seizures could be predicted, some people may have greater freedom and confidence going about each day. They could also intervene and respond ahead of time and ideally prevent or lessen severity of seizures. Currently, there are no prediction devices available, but tremendous efforts are underway. Hopefully, with further study, reliable means of predicting will be available in the near future!

The following list represents seizure prediction methods being studied now:

Using EEG

• Devices have been developed that place electrodes over the brain to constantly measure the brain’s electrical activity.
• The electrodes can record changes in electrical activity before a seizure starts. The potential to predict seizures at this time, based on these EEG changes, is exciting!
• Researchers are still developing the best calculations to predict seizures and limit false alarms and missed seizures.
• A device has been tested on a few patients with epilepsy. More data are needed before this would be ready and available on a wide scale.

Heart Rate

• Some individuals have subtle changes in heart rate immediately before a seizure.
• These changes could provide a potential method to detect seizures and alert someone that a seizure may happen shortly.

Skin

• Changes in skin electrical conduction that can reflect changes in body arousal or stimuli have been seen before some seizures. Changes in breathing patters may occur too.
• Wrist or waist belts can measure these changes, alerting the wearer to an oncoming seizure.

Personal Electronic Devices

• A collaborative effort between Apple and Johns Hopkins University is creating and testing an app for Apple Watch, “EpiWatch.”
• The Apple Watch allows for monitoring heart rate and movement patterns. By collecting data before, during, and after a seizure, researchers hope to be able to predict seizures with this method in the next few years.
• This is in early stages of research right now.
• Other programs for smartphones are being developed as well.

Dogs

• There are anecdotal reports of dogs that are able to predict their owners’ seizures.
• Though individual dogs may seem to be able to predict seizures, there is no standard alerting or training method.
• There are training programs for seizure alert or seizure assistance dogs. These programs teach dogs to help people when they are having a seizure, rather than being able to predict the seizure beforehand.

Self-report by People with Epilepsy

• Many people with epilepsy have found they can predict their own seizures!
• A seizure “prodrome” is the period of time, lasting hours to days, before a seizure when someone feels something “different.”
• This is different than an “aura,” which is actually the beginning of a seizure starting in a small area of the brain.
• A study performed by Dr. Sheryl Haut in 2013 looked at 19 patients that reported they could predict their seizures. These patients were shown to be able to reliably predict their seizures best within a 6 hour window.
• Strategies to modify one’s environment and respond to symptoms prior to a seizure, and ideally abort an event, should be part of epilepsy self-management education.