Can sudden blackouts in a 31-year-old be focal epilepsy?

Question

Hello doctor,

I am 31 years old and have had three episodes of sudden blackouts in the last nine months. My EEG (electroencephalogram) shows epileptiform activity over the temporal lobe, and an MRI (magnetic resonance imaging) of the brain showed some cortical scarring. I am now on Levetiracetam 500 mg twice daily. I work in a high-risk job, so I am scared about restrictions and whether I can drive.

Could you explain whether this is focal epilepsy, and if so, what causes it in someone like me who never had a seizure in childhood?
Also, are there any triggers I should avoid?
Do these medications work long-term, or would surgery be needed?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

I would like you to understand that epileptiform activity in the brain typically means abnormal discharges and electrical activity. In your case, it arises from a part of the brain known as the temporal lobe. So this is a focal temporal lobe epilepsy, which is quite a common type. Taking anti-epileptic medicines as prescribed is very important.

Any epilepsy can generally be triggered by stress, lack of sleep, lack of proper diet, and fever. You must be very careful when engaging in certain activities, such as driving, swimming, or being alone in an elevator. It is best to avoid these situations or try to have someone by your side at all times. Generally, antiepileptic medications, once started, must be taken for at least three years initially.

You need to have a seizure-free period of three years to get these medicines stopped or the dose reduced, as decided by your treating physician. This does not require surgery unless a space-occupying mass in the brain is triggering the seizure. Please share the EEG (electroencephalogram) and MRI (magnetic resonance imaging) reports so that I can gain a better understanding of your condition.

I hope this answers your query. Please let me know if I can assist you further.