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Long-Term Prognosis for Epilepsy

Overview

Epilepsy is a type of neurological disorder known for causing seizures. These seizures can be sporadic and occur without warning, or they might be chronic and occur on a regular basis.

According to the Mayo Clinic, about 80 percent of people with epilepsy require ongoing treatment to prevent seizures from disrupting their daily activities. Preventing seizures can also help keep you and others safe during a sudden episode while walking, driving, or any other activity.

Despite treatment, premature mortality is increased in people with epilepsy. There are a variety of factors that determine epilepsy prognosis. Among these include your:

  • age
  • health history
  • genes
  • severity or pattern of seizures
  • current treatment plan
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Factors affecting prognosis

Factors affecting prognosis

Other factors that can affect your overall prognosis include:

  • Age: Adults over the age of 60 may experience an increased risk for epileptic seizures, as well as related complications.
  • Family history: Epilepsy is often genetic. If you have a family member who experienced epilepsy-related complications, then your own risk may be higher.
  • Infections: These can increase your risk for more seizures — especially brain infections.
  • Preexisting neurological issues: Conditions that include infections, brain trauma, or tumors and autism can all increase the risk of epilepsy.
  • Vascular disorders: Heart disease, stroke, and other vascular disorders can adversely affect your brain. In turn, this can lead to more seizures and subsequent brain damage. You can help minimize this risk factor by adopting heart-healthy lifestyle habits, such as regular exercise and a low-fat/low-sodium diet.

Treatment is one of the most important factors that affect your overall epilepsy prognosis. Antiseizure medication, when taken on a regular basis, can help control activity in the brain that leads to epileptic seizures. In turn, this helps to also minimize risk factors and complications related to epilepsy. Some people eventually stop taking antiseizure medications. This mostly occurs if you’ve been seizure-free for at least two years.

Epilepsy can develop at any age. Early childhood and older adulthood tend to be the most common life stages. The outlook tends to be better for people who develop epilepsy as children — there’s a chance they might outgrow it as they age. Developing epilepsy before the age of 12 increases this positive outcome.

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Complications

Epilepsy complications

Common complications from epilepsy may include:

  • Automobile accidents: A seizure could happen at any time — even when you’re on the road. If you have chronic seizures, you might consider another method of travel, such as having a friend or loved one drive for you.
  • Drowning: The Mayo Clinic estimates that people with epilepsy are up to 19 times more likely to drown than people who don’t have the disorder. Drownings can happen while swimming or bathing.
  • Emotional challenges: Epilepsy can be emotionally overwhelming. Some epilepsy medications can also cause side effects that can affect your emotional well-being. Talk to your doctor if you’re experiencing anxiety, depression, or suicidal thoughts. There are treatments and therapies that can help.
  • Falls: You can also be at risk of falling if a seizure strikes while you’re walking or engaging in other activities while standing up. Depending on the severity of the fall, broken bones and other serious injuries may be possible.
  • Inflammation of the liver: This is caused by antiseizure medications.
  • Pregnancy issues: Pregnant women can’t take antiseizure medications because of possible birth defects, yet seizures can also pose dangers to babies. The best way to prevent pregnancy-related complications is to plan ahead — talk to your doctor about your plans beforehand.
  • Status epilepticus: This is a serious complication that’s a result of numerous, recurring seizures. You might have back-to-back seizures that might last for five minutes or longer at a time. Status epilepticus is an especially dangerous epilepsy complication because it can cause permanent brain damage. Death is also a possibility.
  • Weight gain: Certain antiseizure medications can make weight loss and management more challenging. Being overweight can then increase your risk for other chronic health problems.

Finally, there’s another possible complication, though relatively rare. It’s called sudden unexplained death in epilepsy (SUDEP). According to the Mayo Clinic, this occurs in 1 percent of epilepsy cases. While the exact causes of SUDEP aren’t fully understood, it’s thought that sudden heart or breathing problems may contribute. The risk for SUDEP is higher if your epilepsy isn’t treated.

Childhood is one of the most common life stages when people develop epilepsy. Still, children aren’t as prone to some of the same complications compared with adults. Some children can possibly outgrow the disorder as they get older. The reasons behind this aren’t fully understood.

Natural treatments for epilepsy: Do they work? »

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Studies

What does the research say?

Despite awareness and treatment measures, people with epilepsy are at a higher risk of death than people who don’t have epilepsy. Numerous studies have discussed the mortality rate along with all the possible risks factors involved.

One 2016 study published in Epilepsia highlighted frequent (uncontrolled) generalized tonic clonic seizures as a clear risk factor for sudden unexpected death and also discussed the nocturnal (nighttime) seizures as an additional risk factor. Taking antiseizure medications can reduce the frequency of seizures and helps minimize this risk.

According to Brain: A Journal of Neurology, the risk of sudden death may also be slightly higher shortly after you first start experiencing seizures. This is likely due to the fact that you might be undiagnosed or recently diagnosed, and your medications haven’t taken hold yet.

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