A breakthrough seizure occurs if you’ve had a new episode after being seizure-free for at least 12 months. About 1 in 3 people with epilepsy experience breakthrough seizures and most can achieve remission again.

Epilepsy is a condition that affects your brain. If you have had two or more seizures in your life, a doctor may diagnose you with epilepsy.

According to the World Health Organization, proper treatment can help up to 70% of people with epilepsy achieve remission. That means becoming seizure-free.

But sometimes, after your epilepsy has been managed for some time, you may experience a new seizure. This is known as a breakthrough seizure. You must have been seizure-free for 12 months or more for the new seizure to be a breakthrough.

If you have a breakthrough seizure, you may have to change your treatment plan. Still, you can continue to manage epilepsy after a breakthrough seizure and return to being seizure-free.

The causes of breakthrough seizures are the same as those of other epileptic seizures. But the most common trigger of a breakthrough seizure is missed medication.

Several things can trigger a seizure, and these differ from person to person. Your triggers may also depend on the type of seizures you have. For example, moving patterns or flashes of light can cause seizures in people with photosensitive epilepsy, but not other kinds.

Other triggers for seizures include:

  • stress
  • missed meals
  • dehydration
  • alcohol withdrawal or drinking alcohol
  • hormonal changes during menstruation
  • lack of sleep
  • visual stimulation like flashing lights
  • prescribed medications
  • illegal drugs
  • exposure to poisons or toxins
  • illness

How common are breakthrough seizures?

A 2019 study on breakthrough seizures found 34% of the study population experienced a breakthrough seizure. The study also cited earlier research from 2007 that found about 37% of people with epilepsy have breakthrough seizures.

In the 2019 study, of those who had a breakthrough seizure, 62% achieved another 12-month period of remission within the 2 years following the breakthrough seizure.

Was this helpful?

The symptoms of a seizure can vary widely. The stereotypical image of a seizure involves people falling to the ground and shaking, but many people do not experience this.

Some signs of a seizure include:

  • feeling strange or confused
  • a sense of déjà vu
  • unusual sensory perceptions, like smell and taste
  • stiffness or twitching
  • body movements, like rubbing hands together or fiddling
  • staring blankly
  • eye fluttering
  • jerking movements

The traditional images of a seizure are more common in tonic-clonic seizures, previously called grand mal seizures. Symptoms of these seizures include:

  • sudden loss of consciousness
  • body stiffness
  • jerking of limbs
  • difficulty breathing

If you have epilepsy and think you may have experienced a breakthrough seizure, you should contact your doctor. They can discuss your current treatment plan and whether any changes are necessary.

When is a seizure an emergency?

Not all seizures require emergency attention. Call 911 or your local emergency services in the following circumstances:

  • It is a person’s first seizure.
  • The person has trouble breathing or rousing.
  • There are multiple seizures in a short period of time.
  • The person is injured.
  • The seizure goes on for 5 minutes or more.
  • The person has an additional health concern, like pregnancy or diabetes.
  • The seizure happens while someone is swimming or in water.

The main goal of epilepsy treatment is to manage seizures. Treatment typically involves medication. But options may also range from dietary changes to surgery.

If you experience a breakthrough seizure, you can discuss your current treatment plan with your doctor. Your next steps may depend on various factors, including your overall health.

In the 2019 study of remission after breakthrough seizures, participants took various approaches to their treatment. Of those who achieved remission after a breakthrough seizure:

  • 66% made no changes to their initial treatment plan
  • 32% raised their dosage
  • 2% lowered their dosage

Of those who did not get to remission within 2 years after the breakthrough seizure:

  • 52% made no changes
  • 45% raised their dosage
  • 3% lowered their dosage

The best way to prevent breakthrough seizures is to follow your epilepsy treatment plan. Missed medication is a frequent trigger for breakthrough seizures. Remembering to take your dose may help prevent breakthroughs.

Some ways to keep up with your medication schedule include:

  • Keep a regular dosing schedule.
  • Set an alarm for when it’s time to take the dose.
  • Organize your medications into pill boxes that include the day and time.
  • Work with caregivers to ensure your medication is timely and consistent.

You can also try the following to avoid other seizure triggers:

  • Manage stress through exercise, relaxation techniques, and support groups.
  • Get quality sleep with better sleep hygiene.
  • Eat a nutritious diet and have regular meal times.
  • Avoid alcohol and caffeine.
  • Stay away from medications that increase seizure risk.

But it’s important to know that even if you take your medications as prescribed and do your best to avoid triggers, you may still experience a breakthrough seizure.

Still, you may be able to enter another period of remission after a breakthrough seizure. Your odds of reachieving remission are higher the younger you are.

Most people with epilepsy can stay seizure-free with treatment. A breakthrough seizure happens when you have a seizure after not having one for 12 months. This is most often due to not taking your medication, but other things can also trigger it.

Even if you have a breakthrough seizure, you can still go back into remission. You may not even need to change your treatment plan to achieve this.

If you have epilepsy, try to stick to your treatment plan and avoid triggers to help prevent future breakthrough seizures.

Resources for support

The Epilepsy Foundation has a 24/7 helpline to offer information on treatment, support groups, first aid, and emotional wellness. You can call:

Was this helpful?