Premonitory features and seizure self-prediction: artifact or real?

Seizure prediction is currently largely investigated by means of EEG analyses. We here report on evidence available on the ability of epilepsy patients themselves to predict seizures either by means of subjective experiences ("prodromes"), apparent awareness of precipitants, or a feeling of impending seizure (self-prediction). These data have been collected prospectively by paper or electronic diaries. Whereas evidence for a predictive value of prodromes is missing, some patients nevertheless can forsee impending seizures above chance level. Relevant cues and practical implications are discussed.