Patel Puja, Ferastraoaru Victor, Gold Dov, Lipnick Andrew, Jehle Rana, Haut Sheryl R
Department of Neurology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 201th Street, Bronx, NY 10467, USA; Comprehensive Epilepsy Management Center, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA; The Children's Hospital At Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA.
Department of Neurology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 201th Street, Bronx, NY 10467, USA; Comprehensive Epilepsy Management Center, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
Epilepsy Behav. 2017 May;70(Pt A):193-197. doi: 10.1016/j.yebeh.2017.02.021. Epub 2017 Apr 18.
The unpredictability of seizures causes distress to patients with epilepsy and their caretakers. To date, no studies have explored seizure prediction specifically in the pediatric population. If the period of time preceding a seizure can be reliably identified, either by child or caretaker, there may be a role for pre-emptive interventions. The aim of this study was to investigate caretaker seizure prediction. A questionnaire was distributed to caretakers of patients with epilepsy. The patients were 0-21years old and experienced ≥1 seizure within the past year. We excluded patients with non-epileptic seizures or daily seizures. One hundred and fifty of 240 questionnaires met criteria. Of these, 32 (21.6%) caretakers indicated a positive report of seizure prediction. Age of seizure onset was earlier in the positive predictive group (3.3±3.3years) than in the non-predictor group (5.3±4.8years) (p=0.01). The most common pre-ictal symptoms reported were being tired, hazy look, and sleepiness. A total of 76.6% of caretakers reported at least one seizure precipitant. The prevalence of positive caretaker seizure prediction in this study is similar to that of seizure self-prediction in adult studies. These findings will be used to design prospective online or electronic diary studies to further investigate the caretaker's, as well as children's, perspectives on seizure prediction. We anticipate that this investigation may lead to novel treatments during times of high seizure risk.
癫痫发作的不可预测性给癫痫患者及其照料者带来了困扰。迄今为止，尚无研究专门探讨儿科人群中的癫痫发作预测。如果癫痫发作前的时间段能够被患儿或照料者可靠地识别出来，那么先发制人的干预措施可能会发挥作用。本研究的目的是调查照料者对癫痫发作的预测情况。我们向癫痫患者的照料者发放了问卷。患者年龄在0至21岁之间，且在过去一年中经历过≥1次癫痫发作。我们排除了患有非癫痫性发作或每日发作的患者。240份问卷中有150份符合标准。其中，32名（21.6%）照料者报告有癫痫发作预测的阳性结果。癫痫发作阳性预测组的发病年龄（3.3±3.3岁）早于非预测组（5.3±4.8岁）（p=0.01）。报告的最常见的发作前症状是疲倦、神情恍惚和嗜睡。共有76.6%的照料者报告了至少一种癫痫发作诱发因素。本研究中照料者癫痫发作阳性预测的患病率与成人研究中癫痫发作自我预测的患病率相似。这些发现将用于设计前瞻性在线或电子日记研究，以进一步调查照料者以及儿童对癫痫发作预测的看法。我们预计这项调查可能会在癫痫发作风险高的时期带来新的治疗方法。
