Can a seizure develop for the first time in a 47-year-old?

Question

Hi doctor,

I am 47 and had my first seizure last month with no history of this before. My CT scan was normal but my EEG was borderline abnormal.

Is it possible to have a first seizure disorder at 47?
My doctors said late-onset epilepsy and I was shocked. I do not drink alcohol and have not had a head injury. Could it be that stress or lack of sleep could trigger this out of the blue?
Does having one seizure mean I will need lifelong medication?
I am worried about driving. Work. Losing my independence. How do doctors know if this was a one-time thing or the start of epilepsy?

The uncertainty keeps me in a constant state of anxiety.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Epilepsy (a condition in which a person has repeated seizures caused by abnormal electrical activity in the brain) can develop for the first time in adulthood, even in your 40s or later.

Having one seizure does not automatically mean you have lifelong epilepsy.

Stress, severe sleep deprivation, illness, or certain metabolic imbalances can sometimes trigger a seizure in someone who has never had one before. Sleep deprivation is a well-known trigger.

Your normal CT or computerized tomography scan is reassuring because it makes major structural brain problems less likely. A borderline abnormal EEG (electroencephalogram, a test that records the brain's electrical activity)does not always mean you have epilepsy, but doctors use it along with your medical history, MRI or magnetic resonance imaging findings, and other test results to estimate the risk of another seizure.

Many people who have a single seizure never have another one. Whether you need long-term medication depends on:

MRI and EEG results.
Whether the seizure had a clear trigger.
Whether you experience any additional seizures.

Driving restrictions are common after a seizure for safety reasons, but they are not always permanent.

At this stage, further testing and follow-up with a neurologist will help determine whether this was an isolated seizure or the beginning of epilepsy. It is still possible that this was a one-time event rather than a lifelong condition.

I hope this helps.

Please revert in case of further queries.

Thank you.