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Epilepsy & Behavior
Volume 9, Issue 2, September 2006, Pages 298-306
 
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doi:10.1016/j.yebeh.2006.05.013    
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Copyright © 2006 Elsevier Inc. All rights reserved.

Seizure anticipation: Are neurophenomenological approaches able to detect preictal symptoms?

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Claire Petitmengina, b, Corresponding Author Contact Information, E-mail The Corresponding Author, Michel Baulacc, d and Vincent Navarroc, e

aGroupe des Écoles de Télécommunications, GET/INT, Paris, France

bCentre de Recherche en Épistémologie Appliquée, Paris, France

cEpilepsy Unit, Pitié-Salpêtrière Hospital, Paris, France

dCortex and Epilepsy, INSERM U739, Pitié-Salpêtrière Hospital, Paris, France

eCognitive Neurosciences and Brain Imaging, LENA, CNRS UPR 640, Pitié-Salpêtrière Hospital, Paris, France


Received 20 December 2005; 
revised 3 April 2006; 
accepted 29 May 2006. 
Available online 24 July 2006.

Abstract

Analysis of electroencephalographic signals and several brain imaging studies suggest that a preictal state precedes the onset of seizures. In this study, we used phenomenological strategies to detect modifications in patients’ experience before their seizures. We observed that patients with partial epilepsy feeling an aura (n = 9) frequently experienced prodromes (n = 6). Prodromes were subtle preictal symptoms, varying among patients and having common negative features. They were generally continuous before seizures and could last hours, whereas auras were sudden and intermittent. All patients were able to recognize facilitating factors. We also found that patients spontaneously develop cognitive countermeasures to avoid facilitating factors (n = 6), to prevent a seizure (n = 1) or to interrupt a seizure (n = 5). Prodromes are not specific enough for clinical use, but could refine the behavioral strategies used in the treatment of epilepsy and the pathophysiology of the preictal state.

Keywords: Neurophenomenology; Phenomenology; Epilepsy; Seizure anticipation; Seizure prediction; Aura; Prodrome; Control of epileptic seizures; Behavioral treatment of epilepsy

Article Outline

1. Introduction
2. Methods
2.1. Patient population
2.2. Phenomenological analysis
2.2.1. Collecting descriptions of the preictal subjective experience
2.2.2. Analyzing and comparing the collected descriptions
2.3. Classification of the subjective symptoms
3. Results
3.1. Illustrative example of prodromic sensations
3.2. General results
4. Discussion
4.1. Description difficulties
4.2. Hypothesis of the preictal state
4.3. Countermeasures
4.3.1. Ability to prevent a seizure
4.3.2. Ability to stop a seizure
4.4. Perspectives
5. Conclusion
Acknowledgements
References


Corresponding Author Contact InformationCorresponding author. Present address: 9, rue Charles Fourier, 91011 Evry, France. Fax: +33 01 60 76 44 93.

Epilepsy & Behavior
Volume 9, Issue 2, September 2006, Pages 298-306
 
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