Seizure Prediction

J. Chris Sackellares
2008 Epilepsy Currents  
There is mounting evidence that seizures are preceded by characteristic changes in the EEG that are detectable minutes before seizure onset. Using novel signal analysis techniques, researchers are beginning to characterize the transition from the interictal to the ictal state in quantitative terms. This research has led to the development of automated seizure prediction algorithms. Active debate persists regarding the interpretation of research results, methods of signal analysis, as well as
more » ... erimental and statistical methods for testing seizure prediction algorithms. Developments in this field have led to new theories on the mechanism of seizure development and resolution. The ability to predict seizures could lead the way to novel diagnostic and therapeutic methods for the treatment of patients with epilepsy. The physiological characteristics of a seizure differ dramatically from that of the interictal state. During the interictal state, the EEG typically is lower in amplitude, less rhythmic, and more irregular in morphology. At the onset of a seizure, there is a sudden change in the amplitude, frequency, and morphology of the EEG signal, an increase in rhythmicity, and a synchronization of activity that takes place across widespread areas of the cerebral cortex. The clinical and EEG changes at the onset of a seizure are so dramatic that they give the impression of occurring without any warning or preceding buildup. Although patients sometimes report prodromal symptoms hours to minutes before seizures, the concept of a prodromal change in the EEG was rarely considered, until recently. The shift from the interictal condition, during which the patient is relatively asymptomatic, to the seizure, during which
doi:10.1111/j.1535-7511.2008.00236.x pmid:18488065 pmcid:PMC2384160 fatcat:7wv2b3nhnbdxza6ffsbyuldvkq