How to manage repeated seizures in 19-year-old girls?

Question

Hello doctor,

My 19-year-old daughter had her second seizure yesterday, and I am panicking. The first one was six months ago, and the neurologist said it might be a one-time thing, but now it has happened again. This time, she was driving and crashed into a tree; thankfully, just minor injuries, but it could have been fatal. She is away at college, and I feel helpless being three hours away. The campus health center gave her some basic information, but I need to understand what is happening. She has been stressed about exams and has not been sleeping much, could that trigger seizures? The neurologist wants to start her on anti-seizure medication, but she is worried about side effects and how it might affect her studies. She is majoring in pre-med and is concerned that this will ruin her career plans. I have been researching online, and there is so much conflicting information. Some websites say seizures can be controlled easily, while others mention permanent brain damage. She is my only child, and I am terrified of losing her. Should she drop out of school and move back home? What questions should I ask the neurologist? I need to know how to protect her while still letting her live her life.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Your concern is completely valid; watching your daughter have a second seizure, especially while away at college, is terrifying. But please know this: epilepsy can be managed, and your daughter can still live a full, independent life, including pursuing her dream of becoming a doctor. Here is what you need to know:

1. Two seizures- likely epilepsy.

A second unprovoked seizure, especially six months after the first, usually confirms an epilepsy diagnosis. It is not the end of her future, just the start of treatment. Sleep deprivation, stress, and hormonal shifts are common triggers, especially in young adults. The seizure while driving may result in temporary driving restrictions, depending on state law.

2. Medication is the right step.

After a second seizure, starting an anti-seizure medication is standard. Modern options like Keppra or Lamictal are often effective and have minimal cognitive side effects. Most patients achieve control with the first medication they try. It is about balancing seizure control with side effect management, especially important for her academic focus.

3. Her career is still within reach.

Many physicians live with epilepsy. With good management, medical school is possible. She will need a neurologist who documents her stability, and she can request accommodations if needed. Disclosure is minimal.

4. Dropping out is not necessary.

If she is medically managed and follows safety precautions (avoiding sleep loss, alcohol, and driving for now), she can stay at school. A lighter course load, seizure action plan, and support network on campus can help. Consider seizure alert tech or wearables for added safety.

Ask the neurologist these key questions:

1. What type of seizure is this?

2. What tests have been done or are needed: EEG (electroencephalogram), MRI (magnetic resonance imaging)?

3. What medication is recommended and why?

4. What side effects should we monitor?

5. When can we expect seizure control?

6. How long will she need treatment?

7. Can she safely stay in school?

8. What are the driving restrictions?

9. How can we identify and avoid her triggers?

10. Should we consider genetic testing or specific epilepsy syndromes?

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.