Can patients with epilepsy predict their seizures?
Can patients with epilepsy predict their seizures?
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DOI：
10.1212/01.wnl.0000252352.26421.13
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发表时间：
2007-01-23
期刊：
影响因子：
9.9
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Haut, Sheryl R.;Hall, Charles B.;Lipton, Richard B.
目的：使用前瞻性癫痫日记研究来检验成人患者癫痫发作的可预测性，评估患者预测的有效性，并确定癫痫患者亚组是否能够可靠地预测他们的癫痫发作。方法：符合条件的受试者年龄在18岁或以上，有定位相关癫痫，在12个月内有1次癫痫发作，并能够自我维持发作日记。癫痫发作的自我预测通过评分表进行评估：“你认为你会在接下来的24小时内癫痫发作吗？”癫痫发作预测和癫痫发作的发生被建模为二元结果。或者，计算群体和个人的阳性预测值和阴性预测值，并对人内相关性进行调整。结果：71名受试者返回了15,635个日记条目。癫痫发作的积极预测与癫痫发作风险增加两倍相关(Cochran-Mantel-Haenszel OR 2.25(1.91至2.65))。阳性预测值的特异度为83.2%，敏感度为31.9%。12名受试者(有癫痫发作的受试者的21%)在此预测亚组3.14(2.53至3.89)中显示出显著的个人OR；Cochran-Mantel-Haenszel OR阳性预测。与非预测者相比，预测者更年轻(p=0.026)，癫痫发生率更高(p=0.003)。结论：我们的成年癫痫患者中有相当一部分能够自我预测他们的癫痫发作，这可能会带来新的治疗机会。
Objective: To examine seizure predictability in a cohort of adult patients using a prospective seizure diary study, to assess the validity of a patient's predictions, and to determine if a subgroup of patients with epilepsy were able to reliably predict their seizures. Methods: Eligible subjects were 18 or older, had localization-related epilepsy, had >= 1 seizure within 12 months, and were able to self-maintain a seizure diary. Seizure self-prediction was assessed by a rating scale: "Do you think you will have a seizure in the next 24 hours?" Seizure prediction and seizure occurrence were modeled as binary outcomes. OR, positive predictive value, and negative predictive value were calculated for group and individuals, adjusted for the within person correlations. Results: Seventy-one subjects returned 15,635 diary entries. A positive prediction of seizures was associated with a twofold increased risk of seizure (Cochran-Mantel-Haenszel OR 2.25 (1.91 to 2.65). Overall, the specificity of positive prediction was 83.2% while the sensitivity was 31.9%. Twelve subjects (21% of subjects who had seizures) demonstrated significant within person OR; Cochran-Mantel-Haenszel OR for positive prediction in this predictor subgroup 3.14 (2.53 to 3.89). Predictors were younger (p = 0.026) and had a higher seizure rate (p = 0.003) than nonpredictors. Conclusions: A significant subgroup of our adult patients with epilepsy were able to self-predict their seizures, which may yield novel therapeutic opportunities.