Dealing with a breakthrough seizure? Here’s what you need to know

  • January 12, 2023
  • 4
In this article

Have you recently had a breakthrough seizure? This can be frustrating and confusing. After months of seizure freedom, these sorts of events can really knock your confidence. 

You’ll likely have a lot of questions about breakthrough seizures. Why do they happen? Will you now have more seizures? What does it mean for your treatment plan? 

Let’s learn about the causes of breakthrough seizures, and what they mean for you.

What is a breakthrough seizure?

A breakthrough seizure is when you have a seizure after you haven’t had one for an extended period of time while being treated for epilepsy. It’s usually considered to be after 12 months of seizure freedom. They are quite common -  over a third of people who achieve seizure freedom will have a breakthrough seizure at some point. 

It’s also common to have at least one more seizure after your first breakthrough seizure. The good news is that most people then return to extended periods of seizure freedom.  

What are the causes of breakthrough seizures? 

There are many different reasons you might have a breakthrough seizure. Here are some of the common causes of breakthrough seizures:

  • Forgetting to take your medication

This is the top reason that people have breakthrough seizures, according to a study in Egypt. People with epilepsy may forget to take their medication for many different reasons. There are also times that some people with epilepsy find that the side-effects of their medication are very strong, so they reduce their dosage to avoid this without their doctor’s approval. 

  • Being tired

Having poor sleep is another major reason people have breakthrough seizures. Being very tired can affect your brain’s activity - see our article on sleep to learn more. 

  • Stress

If you’re feeling anxious and stressed, then this could also make it more likely you’ll have a breakthrough seizure. Stress affects how your brain works, and could trigger a seizure. Read our article on stress management for more information. 

  • Drug interactions

Many different medications and drugs (including alcohol and caffeine) can affect your brain activity or the levels of anti-epilepsy medication in your bloodstream. That can then make them less effective, and mean you have a breakthrough seizure. Read our article on drug interactions here

  • Your personal treatment history

Research shows that people who took longer to get diagnosed or who took longer to find a suitable epilepsy treatment, are more likely to have breakthrough seizures. 

  • Infections or head injuries

If you have a high fever or some kind of head injury while you’re seizure free, this could also trigger a breakthrough seizure. 

  • Hormonal changes

Another cause of breakthrough seizures are hormonal changes. This particularly affects women during their periods. 

While these are some of the more common causes of breakthrough seizures, we often don’t know why they happen. 

Triggers: 7 seizure triggers to be aware of

What to do if you’ve had a breakthrough seizure

Once you’ve recovered from your breakthrough seizure, the most important thing to do is to schedule an appointment with your epilepsy specialist. They can do an examination and try to figure out the cause. Everyone’s different, but they might recommend the following kinds of things:

  • Finding new ways to remember your medication - you can use Epsy to set up med reminders and to log when you’ve taken a medication
  • Increasing the dose of your seizure medicine might help if you’re confident you have not forgotten your meds, or that drug interactions weren’t the cause
  • Lifestyle changes could also be part of the solution - finding ways to manage stress, reduce alcohol consumption and sleeping better can all help

Staying positive after a breakthrough seizure

Having a breakthrough seizure can be really distressing - you might feel like you’ve gone ‘back to square one’. This is totally understandable, but remember that statistics show that most people return to seizure freedom quite soon after having a breakthrough seizure.

Your doctor can provide advice for your situation, but by recording any events in Epsy, setting med reminders, and considering some simple lifestyle changes, there’s a good chance you can get back in control fast.

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