This content does not have an Arabic version. Overview A seizure is a sudden, uncontrolled electrical disturbance in the brain. Latest on newly diagnosed epilepsy care Advice for the management of epilepsy Error Select a topic. Thanks for Subscribing You will receive the first epilepsy email message in your inbox shortly. You may opt out of these emails any time by clicking the unsubscribe link in the email. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Schachter SC. Evaluation and management of the first seizure in adults. Accessed Sept. Daroff RB, et al. In: Bradley's Neurology in Clinical Practice. Elsevier; Accessed May 5, The epilepsies and seizures: Hope through research. National Institute of Neurological Disorders and Stroke. Types of seizures. Epilepsy Foundation. Accessed Sep.
First seizure adult. Mayo Foundation for Medical Education and Research; Seizure first aid. Centers for Disease Control and Prevention. Haider HA, et al.
Neuroimaging in the evaluation of seizures and epilepsy. Neurological diagnostic tests and procedures fact sheet. Schachter SC. Overview of the management of epilepsy in adults.
Crepeau AZ, et al. The rapid withdrawal of barbiturates phenobarbital and Mysoline [primidone] and benzodiazepines are associated with the highest risk of a seizure or unpleasant symptoms such as anxiety, irritability, a racing heart, difficulty sleeping, sweating, abdominal pain, vomiting, and problems with concentration.
Benzodiazepines used to control seizures include:. All withdrawal symptoms are reduced and in many cases eliminated when the dosage is lowered slowly. When seizure medicines are properly discontinued slowly, the risk of a withdrawal seizure is very small.
Rapid discontinuation of any seizure medicine can be dangerous, however, and should only be done under a doctor's supervision. Abrupt withdrawal can cause dangerous, long-lasting seizures called status epilepticus. When an antiepileptic drug is tapered or withdrawn, seizures may occur simply because the drug was needed to control them.
Depending on the type and severity of the seizures, the medications may need to be re-started, although the child may remain seizure-free at a lower dosage than before.
Differentiating this type of seizure recurrence from a withdrawal seizure is important, because withdrawal seizures can be managed by a temporary increase in the dosage followed by more gradual tapering. If the medications are stopped, the child, family, and school need to be prepared for the possibility that a seizure could occur.
If the child has been seizure-free for 2 years or more, people tend to forget to take precautions. During the tapering and for at least 3 to 6 months after stopping the medications, the child's risk of a seizure is somewhat higher than usual.
Three-quarters of seizure relapses occur within 1 year of stopping the medication. During this time, simple precautions should be taken, such as:. If a seizure occurs after a period of freedom from seizures, it is an emotional setback for both the child and the family. Parents must be prepared for this possibility and discuss it with the child.
When people are aware that something is possible, they are much better able to handle it if it happens. Although children often will privately worry about the possibility of having another seizure, their fear diminishes with time. A rare consequence of discontinuing the medication is the reemergence of difficult-to-control seizures or the development of intolerance to a medication that was previously well tolerated.
Luckily, these situations are very uncommon. In the best of all worlds, when the medications are stopped, seizures will not recur and the child will enjoy the freedom of good health without medication. When a child has been taking a medication for more than 2 years, it can be difficult to estimate the effect that it has on the child's behavior.
This is particularly true if the dosage was gradually increased over a long period. In many cases, although the medication was thought to have no unwanted side effects, the child's alertness, ability to concentrate, memory, ability to reason, and behavioral problems such as irritability and hyperactivity improve after the medication is stopped. Some seizure medicines, however, can have positive effects on a child's behavior, and occasionally their discontinuation is associated with increased behavioral problems.
Some of the medications that may have this effect are:. For a few people, long exposure to a medication usually more than 2 to 5 years can cause problems such as thinning bones. Phenobarbital and Dilantin phenytoin can cause soft-tissue growths. Dilantin or Phenytek can also cause nerve injury, excessive hair growth, and damage to the cerebellum of the brain, which helps with coordination. Finally, girls who continue taking medication and want to become pregnant later in life will expose their babies to a higher-than-normal risk of birth defects.
All of these problems can be avoided by stopping the medications as soon as possible. And because we cannot assess all of the long-term consequences of taking medications, discontinuing them may have other benefits that we haven't discovered.
Although most forms of childhood epilepsy are outgrown, some forms are associated with a high risk of recurrent seizures if the medications are stopped. Sometimes we can prevent epilepsy. These are some of the most common ways to reduce your risk of developing epilepsy:. Read more about epilepsy prevention.
A person who has a seizure for the first time should talk to a health care provider, such as a doctor or nurse practitioner. The provider will talk to the person about what happened, and look for the cause of the seizure. Many people who have seizures take tests such as brain scans for a closer look at what is going on.
These tests do not hurt. Learn more about how epilepsy is diagnosed external icon from the Department of Veterans Affairs. There are many things a provider and person with epilepsy can do to stop or lessen seizures. Read more about the treatment options for epilepsy in the National Institute of Neurological Disorders and Stroke publication: Seizures and Epilepsy: Hope Through Research external icon. Many kinds of health providers treat people with epilepsy. Primary care providers such as family physicians, pediatricians, and nurse practitioners are often the first people to see a person with epilepsy who has new seizures.
These providers may make the diagnosis of epilepsy or they may talk with a neurologist or epileptologist. A neurologist is a doctor who specializes in the brain and nervous system. An epileptologist is a neurologist who specializes in epilepsy. When problems occur such as seizures or side effects of medicine, the primary health provider may send the patient to a neurologist or epileptologists for specialized care. People who have seizures that are difficult to control or who need advanced care for epilepsy may be referred to an epilepsy centers.
Epilepsy centers are staffed by providers who specialize in epilepsy care, such as. Many epilepsy centers work with university hospitals and researchers. There are several ways you can find a neurologist or an epileptologist near you. Your primary care or family provider can tell you about types of specialists. The American Academy of Neurology external icon and the American Epilepsy Society external icon provide a listing of its member neurologists and epilepsy specialists, including epileptologists.
The National Association of Epilepsy Centers external icon also provides a list of its member centers, organized by state. Self-management is what you do to take care of yourself.
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