Epileptic Seizure Paediction: dead ends or new options
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2009-07-16
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en
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Twenty-five procent of the epileptic patients today are untreatable [1]. They have to live with the (seemingly) unpredictable nature of their disorder. An epileptic seizure prediction system could make a large improvement to their lives. For almost forty years attempts have been made to find a suitable precursor in (intracranial) electroencaphologram (EEG) measurements, with no good results so far. In this study four measures are compared with respect to their capability to predict seizures for three patients with a focal epileptic disorder with a frontal origin and a γ-onset as initial morphology. The performance of a measure was defined as the area under the receiver operating characteristic (ROC)-curve for the distributions of pre- and interictal time profiles. Andrzejak's test was applied to investigate to what extent the performance of a measure was based on epilepsy related factors [2]. The measures appear to have no real predictive power. Even when they appear to be able to discriminate between pre-and interictal activity, the score on Andrzejak's test suggests that the observed differences were due to non-epileptic factors. So this study yields yet another confirmation that precursors in intracranial EEG measurements are very hard to find. Perhaps it is time to change tracks after 40 years of largely unsuccessful efforts and try other measurements, not related to EEG. A potentially fruitful alternative
is the electrocardiogram (ECG) which is related to the reported clinical prodromi [3] and it adds the considerable bonus that it is far less invasive than EEG.
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Faculteit der Sociale Wetenschappen