Besag Frank M C, Vasey Michael J
East London Foundation NHS Trust, 5-7 Rush Court, Bedford MK40 3JT, UK; University College, London, UK; King's College, London, UK.
Epilepsy Behav. 2018 Jun;83:219-233. doi: 10.1016/j.yebeh.2018.03.019. Epub 2018 Apr 10.
Prodromal symptoms (PS) of epileptic seizures are clinically well-recognized but relatively little researched. The purpose of this review was to examine the evidence in the literature for the existence of prodrome and the reported frequency and nature of prodromal characteristics.
We performed a PubMed review of the clinical characteristics, frequency, and duration of PS in papers published between 2007 and 2017. We also reviewed findings from prospective studies into the predictive performance of prodrome. In a second analysis, we reviewed studies reporting a single symptom/sign of prodrome.
In 8 studies reporting on the prevalence of prodrome, we found a mean frequency of 21.9%. The most frequent symptoms were "funny feeling" (10.4%), confusion (9.0%), anxiety (8.6%), and irritability (7.7%), but other features were also reported. The duration of prodrome was typically between 10min and 3days, with most prodromes lasting for between 30min and 24h. In studies that reported a single prodromal symptom/sign, headache was the most frequent: 8% with a range of between 1.2 and 30%.
Prodromes are characterized by a broad spectrum of preictal symptoms that may be experienced for a duration of between 10min and several days, which usually persist until seizure onset. Opinion is divided on their precise nature and value as predictors of seizures. A greater understanding of prodromes might offer insights into the preictal period and hold promise for new seizure management therapies.
癫痫发作的前驱症状在临床上已得到充分认识，但相关研究相对较少。本综述的目的是考察文献中关于前驱症状存在的证据以及所报道的前驱特征的频率和性质。
我们对2007年至2017年间发表的论文中前驱症状的临床特征、频率和持续时间进行了PubMed检索。我们还回顾了关于前驱症状预测性能的前瞻性研究结果。在第二项分析中，我们回顾了报告前驱症状单一症状/体征的研究。
在8项报告前驱症状患病率的研究中，我们发现平均频率为21.9%。最常见的症状是“奇怪的感觉”（10.4%）、意识模糊（9.0%）、焦虑（8.6%）和易怒（7.7%），但也有其他特征的报道。前驱症状的持续时间通常在10分钟至3天之间，大多数前驱症状持续30分钟至24小时。在报告单一前驱症状/体征的研究中，头痛最为常见：8%，范围在1.2%至30%之间。
前驱症状的特点是发作前症状范围广泛，可能持续10分钟至数天，通常一直持续到癫痫发作开始。关于它们作为癫痫发作预测指标的确切性质和价值，存在不同观点。对前驱症状的更深入了解可能有助于深入了解发作前期，并有望带来新的癫痫治疗方法。
