epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333/epi.par.con.2026.272epilepsia-1353Research ArticleSCIENTIFIC SURVEYSНАУЧНЫЕ ОБЗОРЫPreictal warning phenomena in focal epilepsyПреиктальные предупреждающие феномены при фокальной эпилепсииhttps://orcid.org/0000-0002-6184-9206НародоваЕ. А.NarodovaE. A.

Народова Екатерина Андреевна, д.м.н., проф.

WoS ResearcherID: AAM-9051-2020. Scopus Author ID: 57203353014

ул. Партизана Железняка, д. 1, Красноярск 660022

Ekaterina A. Narodova, Dr. Sci. Med., Prof.

WoS ResearcherID: AAM-9051-2020. Scopus Author ID: 57203353014

1 Partizan Zheleznyak Str., Krasnoyarsk 660022

 

katya_n2001@mail.ruhttps://orcid.org/0000-0003-4081-5805НародоваВ. В.NarodovaV. V.

Народова Валерия Вячеславовна, д.м.н., проф.

ул. Партизана Железняка, д. 1, Красноярск 660022

Valeriia V. Narodova, Dr. Sci. Med., Prof. 

1 Partizan Zheleznyak Str., Krasnoyarsk 660022

ЕрахтинЕ. Е.ErakhtinE. E.

Ерахтин Евгений Евгеньевич

ул. Курчатова, д. 17, Красноярск 660062

Evgeny E. Erakhtin 

17 Kurchatov Str., Krasnoyarsk 660062

Федеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет им. профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииРоссияVoino-Yasenetsky Krasnoyarsk State Medical UniversityRussian FederationКраевое государственное бюджетное учреждение здравоохранения «Красноярская межрайонная клиническая больница скорой медицинской помощи им. Н.С. Карповича»РоссияKarpovich Krasnoyarsk Interdistrict Clinical Hospital of Emergency Medical СareRussian Federation202603082026182173–180Copyright © Narodova E.A., Narodova V.V., Erakhtin E.E., 20262026Народова Е.А., Народова В.В., Ерахтин Е.Е.Narodova E.A., Narodova V.V., Erakhtin E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/1353Objective

Objective: To summarize current evidence on the prevalence, phenomenology, and temporal characteristics of prodromal symptoms and early ictal manifestations (auras) in focal epilepsy, and to clarify their clinical relevance for patient counseling and management.

Material and methods

Material and methods. A narrative review of the literature on prodromal symptoms and auras in focal epilepsy was conducted. Publications were identified through searches in PubMed/MEDLINE and by screening reference lists of key articles. Given the heterogeneity in definitions and time frames across studies, findings were analyzed qualitatively without meta-analysis, particularly emphasizing on practical aspects of clinical interviewing and safety recommendations.

Results

Results. Prodromal symptoms are reported in a substantial proportion of patients with focal epilepsy; reported prevalence varies depending on assessment methods and diagnostic criteria. Prodromes typically occur minutes to hours (less commonly a day or more) before seizure onset and may include affective, cognitive, and autonomic manifestations. According to the current classification by the International League Against Epilepsy, an aura is defined as a focal aware seizure and represents the ictal phase of the epileptic event. Clinically, auras are characterized by brief, stereotyped subjective experiences occurring seconds to minutes before potential seizure propagation. Patients’ responses to warning symptoms often include cessation of ongoing activities, seeking a safe environment, and alerting others, which may reduce the risk of injury. However, in some individuals, anticipatory anxiety and avoidance behaviors develop, negatively affecting quality of life.

Conclusion

Conclusion. In patients with focal epilepsy, routine and systematic inquiry about prodromal symptoms and auras during clinical evaluation is advisable. Clinicians should carefully distinguish between prodromal and early ictal manifestations and help patients adopt proportionate safety measures without reinforcing hypervigilance or unnecessary restrictions in daily activities.

Цель

Цель: обобщить данные о распространенности, феноменологии и временных характеристиках продромальных симптомов и ранних иктальных проявлений (ауры) при фокальной эпилепсии и определить их клиническое значение для консультирования и ведения пациентов.

Материал и методы

Материал и методы. Проведен обзор публикаций, посвященных продромальным симптомам и ауре при фокальной эпилепсии, а также поведенческим реакциям пациентов на предупреждающие ощущения. Поиск литературы осуществляли в базе PubMed/MEDLINE и по спискам литературы ключевых работ. С учетом разнородности определений и временных интервалов результаты проанализированы качественно, без метаанализа, с акцентом на практические аспекты клинического расспроса и рекомендаций по безопасности.

Результаты

Результаты. Продромальные симптомы отмечаются у значительной части пациентов – частота сообщений варьируется в зависимости от методики выявления и используемых критериев. Продром обычно развивается за минуты или часы (реже за сутки и более) до приступа и включает аффективные, когнитивные и вегетативные проявления. В современной классификации Международной Противоэпилептической Лиги аура рассматривается как фокальный приступ с сохраненным осознанием и относится к иктальной фазе эпилептического события. Клинически она проявляется кратковременными стереотипными ощущениями, возникающими за секунды или минуты до возможного распространения приступа. Реакции пациентов на предупреждающие ощущения включают прекращение активности, поиск безопасных условий и информирование окружающих, что может снижать риск травм. Вместе с тем у части больных формируются антиципаторная тревога и избегающее поведение, отрицательно влияющие на качество жизни.

Заключение

Заключение. При фокальной эпилепсии целесообразно систематически уточнять наличие продромальных симптомов и ауры в ходе клинического приема. Важными задачами являются разграничение продрома и ранних иктальных проявлений, а также формирование у пациента соразмерных мер безопасности без усиления гипербдительности и неоправданных ограничений повседневной активности.

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The authors declare that there are no conflicts of interest present.