Journal article

Tracking seizure cycles beats a prospective moving average: Commentary on "Rigorous evaluation of five e-diary alone seizure forecasting tools"

RE Stirling, BH Brinkmann, DR Freestone, PJ Karoly

Epilepsia | Published : 2026

Abstract

There is debate on the predictive value of multiday seizure cycles versus simple statistical baselines. Multidien seizure cyclicity is a prevalent, patient-specific phenomenon with promise for epilepsy management. We challenge the assertion that cycle tracking is no better than a moving average, which is an inherently retrospective model that lags changes in seizure likelihood. This commentary compared a causal cyclic forecast to a prospectively applied moving average across a large seizure diary cohort (n = 768) and two gold-standard chronic EEG cohorts (n = 24). For the EEG and diary cohorts, cycle tracking demonstrated significantly superior accuracy to the moving average for both hourly ..

View full abstract