The risk of seizures within the next 24 hours can be predicted by watching for abnormal brain activity patterns in people with epilepsy, a new study finds.

The storm of brain activity that characterized a seizure is presaged by abnormal communication between specific areas of the brain, researchers discovered.

They say they can forecast seizure risk by analyzing just 90 seconds of these aberrant brain signals, according to their report published in the journal Nature Medicine.

If validated, this discovery could help improve quality of life for the 2.9 million Americans living with epilepsy, researchers said.

“Until now, the changes in brain activity and the sequence of events leading up to a seizure have been largely unknown,” said lead researcher Dr. Vikram Rao, a professor of neurology at the University of California, San Francisco (UCSF). 

“By identifying one of those events, we can offer patients information that can reduce one of the most stressful aspects of epilepsy: the unpredictability of seizures,” Rao added in a UCSF news release.

Current methods used to predict seizures require data gathered over long periods of time, and accuracy varies widely based on the individual and the method being used.

Some patients with epilepsy have implants that monitor brain activity and attempt to head off seizures with electrical stimulation, researchers said in background notes. Unfortunately, these devices sometimes respond too late to stop a seizure.

To make such implants more effective, Rao’s team studied 15 people with epilepsy in hopes of identifying a common brain activity pattern that foreshadows a seizure. The participants had implants that had recorded months of brain activity, which the researchers analyzed for clues.

“Patients aren’t always having seizures, but their epilepsy never goes away,” said researcher Ankit Khambhati, an assistant professor of neurosurgery with UCSF. “We wanted to find a signature of how patients’ brains are operating long before an event, while the disease is there in the background but they’re not having an episode.”

The participants all had seizures that arise from the hippocampus, a region found in both sides of the brain that plays a role in most types of epilepsy.

The researchers found that communication between the two hippocampi changes in the days leading up to a seizure.

The right and left hippocampus operate independently when the brain is functioning normally, researchers said.

But seizure risk increased when the two hippocampi began to communicate with each other, results show. The pattern was similar for virtually all the participants.

As little as 90 seconds of data is sufficient to spot this pattern and judge the likelihood of a seizure within the next 24 hours, researchers said.

A day’s warning can provide an epileptic time to take precautions, like avoiding driving or making sure they have someone ready to support them in the event of a seizure, researchers said.

“People with epilepsy often live in so much fear of having an unpredictable event that they avoid doing things they’d like to do,” Khambhati said. “These forecasts can give them confidence that they can just go out and have a normal day.”

The team plans to test this new approach in larger number of patients and in people who suffer from different types of epilepsy.

They also hope to develop a method for scanning the brain that doesn’t require an implant.

More information

The Epilepsy Foundation has more about epilepsy.

SOURCE: University of California, San Francisco, news release, July 2024

Source: HealthDay