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In Epilepsia

A reliable identification of a high-risk state for upcoming seizures may allow for preemptive treatment and improve the quality of patients' lives. We evaluated and not evaluate the ability of prodromal symptoms to predict preictal states using a machine learning (ML) approach. Twenty-four patients with drug-resistant epilepsy were admitted for continuous video-electroencephalographic monitoring and filled out a daily four-point questionnaire on prodromal symptoms. Data were then classified into (1) a preictal group for questionnaires completed in a 24-h period prior to at least one seizure (n1  = 58) and (2) an interictal group for questionnaires completed in a 24-h period without seizures (n2  = 190). Our prediction model was based on a support vector machine classifier and compared to a Fisher's linear classifier. The combination of all the prodromal symptoms yielded a good prediction performance (area under the curve [AUC] = .72, 95% confidence interval [CI] = .61-.81). This performance was significantly enhanced by selecting a subset of the most relevant symptoms (AUC = .80, 95% CI = .69-.88). In comparison, the linear classifier systematically failed (AUCs < .6). Our findings indicate that the ML analysis of prodromal symptoms is a promising approach to identifying preictal states prior to seizures. This could pave the way for development of clinical strategies in seizure prevention and even a noninvasive alarm system.

Cousyn Louis, Navarro Vincent, Chavez Mario


epilepsy, machine learning, preictal state, prodromal symptoms, prodromes, seizure prediction