Maybe a silly question?

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JoeP

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I have been reading in posts and from time to time I see "breakthrough" seizures mentioned. Can anyone tell me what these are?
 
usually that means someone doesnt have a tonic clonic very often and sometimes if meds or diet is changed, or lifestyle is changed. it could cause the seizure threshold to lower enough for a seizure to "breakthrough".

with those that dont have TCs it means that they are normally very well controlled by meds or other means and something they did caused that type of seizure to happen, or again, "breakthrough" their threshold.

No question is stupid. :O)
 
Hi Joe,

A "breakthrough seizure" is a sudden unexpected seizure in someone who has had them well controlled for a long time. They may be due to lack of medication, stress, illness or a number of other issues.
 
I usually have tonic-clonics, but occasionally when I've been slightly under-dosed, I've had tiny brain blips -- as if the switch in my brain had been flicked on and off in a fraction of a second. My neurologist referred to these "blips" as breakthrough seizures.
 
I have very strong trance-like deja vu auras. Sometimes they lead to t/c events. I consider it a "breakthrough" when I've been seizure free for a long period of time, and than, for whatever reason, start having auras again.
 
That's kinda what I thought. I have had my seizures controlled very well, haven't had one since 1992. I went to see a neurologist and he switched my medications from Dilantin to generic Keppra. I am up to 2000mgs/ day of the generic and am now down to 200mg of Dilantin for 4 more days then 100mg/day for 5 days then off of it completely. I am a little nervous since they have been under control for so long. We'll see. This new stuff makes me irritated and angry very easy, am going to talk to my neurologist about taking B6, see if that helps.
 
Joe -- Since you were doing fine on the Dilantin, why did your neurologist want to switch you?
 
Hi, Joe,

All questions are good questions. If you are wondering about something, odds are 10 other people in here are wondering about it, too.

I agree with the previous description of breakthrough seizures. And I'll add a bit. If someone's seizures have been well controlled and then they have a seizure, it's a breakthrough seizure. My neurologist counts all possible kinds of seizures, including auras, as breakthrough seizures. He wants them ALL under control. Some doctors don't count auras, some do.

In addition to changes in meds, diet, stress, routine, sometimes we do things that affect our absorbtion of the anti-seizure medication. That was true for me once when I had an upset tummy and took Pepto Bismol. I thought it only affected your stomach and wouldn't affect absorbtion in the intestine, but I think I was wrong. I had a bunch of breakthrough seizures later. (Or, it may have happened because I was sick - who knows?) Also there are some meds where you can't eat grapefruit. I have a suspicion that excessive drinking or meds that are also metabolized through the liver (or some meds, the kidney) also delay or prevent the anti-seizure meds being metabolized.

Some people get acclimatized to their anti-seizure meds and they quit working as well, and they get breakthrough seizures, too.

All this are reasons why a seizure journal is so important. It helps track all this stuff, which helps us figure out why a breakthrough seizure happened, and how long it's been since we've had our last seizure.
 
Switched because my wife and I were worried of the long term effects. Such as liver functionality and stroke.
 
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Ah... I get it. For a very small percentage of people it makes their brain shrink. I tried to find the exact odds but couldn't find it. It's actually used as a treatment for some with brain swelling and/or a tumor.
 
Brain shrinkage had nothing to do with it! We were worried about the possibility of stroke or liver damage, did not want my wife to have to raise 3 kids by herself.
 
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