Nikesh Ardeshna, MD, MS
Epilepsy fellow at
Wayne State University,
Detroit Medical Center
Kore Liow, MD
Director, Via Christi Comprehensive Epilepsy Center
Clinical Associate Professor of Medicine (Neurology) and Psychiatry
Kansas School of Medicine-Wichita
Sandra Helmers, MD
Associate Professor of Neurology
Emory University School of Medicine
Anup Patel, MD
Pediatric Epilepsy Specialist
Capitol Neurology Group
Riley Hospital for Children
Gregory Holmes, MD
Chief of the Neurology Section, Dartmouth Medical School
Past President, American Epilepsy Society
Elizabeth A. Thiele, MD, PhD
Director of the Pediatric Epilepsy Program
Massachusetts General Hospital
John Pellock, MD
Professor and Chairman, Division of Child Neurology
Virginia Commonwealth University
Questions About Adult Epilepsy
“Seizure types may vary with age,” Elizabeth Thiele says. “Adults are more apt to have partial complex seizures.” Partial complex seizures can result in a specific disruption of brain activity, such as head trauma, stroke, or brain tumor. Generalized seizures, however, seem to be the result of genetic disorders, and are not as common by comparison. While there are several generalized epilepsies, fewer adults have these types of seizures. In children, however, generalized epilepsies, including myoclonic seizure types and complex-partial seizures, are more common.
“The causes of epilepsy can range from tumors or infection to damage to the brain due to head injury,” says Thiele. Many different causes can result in similar-looking seizure types. Likewise, a single cause can result in many different types of seizures. For example, she says, patients experiencing early-onset seizures—such as infantile spasms—can later develop generalized or other seizure types.
“If your seizures consistently last longer than usual, you should see your neurologist (or primary care physician),” Nikesh Ardeshna says. “This difference does not necessarily mean a change in medications is needed. A patient with epilepsy may just require a change in their medication dosage. Never make changes to your dosage on your own. Always talk with your doctor and take the prescribed amount of your medication. The physician will inquire about and look into causes that might have contributed to the increased duration of seizures such as antiepilepsy drug level, or illness, such as the flu.”
“In general, even though seizure symptoms may change, the root cause is likely the same,” Thiele says. “Most of the time, we try new medications in the hopes of achieving better control. But with refractory epilepsy that proves difficult to control, we look at all possible options.” If, for example, the patient has undergone some change or developmental maturation, a medication not previously effective may be more effective, and worth a second try. A previously tried medication may also be useful in combination with other medications.
Questions About Childhood Epilepsy
“Seizure types may vary with age,” Elizabeth Thiele says. “Adults are more apt to have partial complex seizures.” Partial complex seizures can result in a specific disruption of brain activity, such as head trauma, stroke, or brain tumor. Generalized seizures, however, seem to be the result of genetic disorders, and are not as common by comparison. While there are several generalized epilepsies, fewer adults have these types of seizures. In children, however, generalized epilepsies, including myoclonic seizure types and complex-partial seizures, are more common.
Read more Doctor Q&A in our archive.