Can You Predict Your Own Seizures?

In the early view of the journal Epilepsia, Drs. Haut and colleagues present a fascinating study in which an electronic diary was utilized to assess whether one can predict one’s own seizure. Because a previous group of patients with epilepsy successfully self-predicted seizures in a paper diary study, the investigators conducted an electronic diary study to ensure that prediction precedes seizures and to characterize those features and time windows that are associated with predicting one’s own seizures.

Patients who are 18 years and older who had localization-related epilepsy with more than three seizures per month maintained a seizure diary in which they recorded premonitory symptoms, mood, and all seizures. The results of the study were as follows.

• During the study, 19 subjects reported that they were able to accurately predict seizures.
• Prediction was most robust within a six-hour time period of diary entry and remained significant for up to 12 hours. The average sensitivity was about 50%.
• The older the patient the more likely the patient was able to successfully predict a seizure.
• Seizure occurrence, self-prediction, favorable change in mood, and a number of premonitory symptoms were most significant predictors.

The authors concluded that:

• Some persons with epilepsy can self-predict seizures. In these individuals, the odds of a seizure following a positive prediction are quite high and are not attributable to remembering the seizure and are more associated to self-awareness.
• A six-hour prediction window may be suitable for the development of treatment that can be delivered to prevent a seizure from occurring at that time.