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Updated: Mar 22, 2026
Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
Published on: July 8, 2025
Predictability of uncontrollable multifocal seizures - towards new treatment options
Klaus Lehnertz1,2,3, Henning Dickten1,2,3, Stephan Porz1,2
1Department of Epileptology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Abstract:
Drug-resistant, multifocal, non-resectable epilepsies are among the most difficult epileptic disorders to manage. An approach to control previously uncontrollable seizures in epilepsy patients would consist of identifying seizure precursors in critical brain areas combined with delivering a counteracting influence to prevent seizure generation. Predictability of seizures with acceptable levels of sensitivity and specificity, even in an ambulatory setting, has been repeatedly shown, however, in patients with a single seizure focus only. We did a study to assess feasibility of state-of-the-art, electroencephalogram-based seizure-prediction techniques in patients with uncontrollable multifocal seizures. We obtained significant predictive information about upcoming seizures in more than two thirds of patients. Unexpectedly, the emergence of seizure precursors was confined to non-affected brain areas. Our findings clearly indicate that epileptic networks, spanning lobes and hemispheres, underlie generation of seizures. Our proof-of-concept study is an important milestone towards new therapeutic strategies based on seizure-prediction techniques for clinical practice.
Insights
Seizure prediction is now feasible for difficult-to-treat, multifocal epilepsies. This study shows electroencephalogram-based prediction can identify seizure precursors in non-affected brain areas, paving the way for new therapies.
Area of Science:
- Neurology
- Biomedical Engineering
- Epilepsy Research
Background:
- Drug-resistant, multifocal, and non-resectable epilepsies present significant management challenges.
- Current seizure prediction methods are effective primarily for patients with single seizure foci.
- A critical need exists for advanced seizure control strategies in complex epilepsy cases.
Purpose of the Study:
- To evaluate the feasibility of electroencephalogram (EEG)-based seizure prediction in patients with uncontrollable, multifocal seizures.
- To determine if seizure precursors can be identified in patients with widespread epileptic networks.
- To advance therapeutic strategies for difficult-to-manage epilepsy.
Main Methods:
- Utilized state-of-the-art, EEG-based seizure-prediction techniques.
- Assessed predictive accuracy in patients with multifocal, drug-resistant epilepsy.
- Analyzed the location of emergent seizure precursors within the brain.
Main Results:
- Achieved significant seizure prediction in over two-thirds of participating patients.
- Unexpectedly found seizure precursors emerged in brain areas not traditionally considered affected.
- Demonstrated the potential for ambulatory seizure prediction in complex epilepsy.
Conclusions:
- Epileptic networks spanning multiple lobes and hemispheres are crucial for seizure generation.
- EEG-based seizure prediction is feasible even in complex, multifocal epilepsy cases.
- This proof-of-concept study supports the development of novel, prediction-guided epilepsy therapies.
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