I am 32. What should I do if I get another seizure attack?

Question

Hello doctor,

I am 32 years old, and had my first seizure three weeks ago while at work. My colleagues said I fell, my whole body was shaking, and I was unconscious for about two minutes with confusion afterward. I have no memory of the event, but since then, I have been having these weird episodes where I stare off into space and feel disconnected from reality for 10 to 20 seconds.

My neurologist ordered an EEG and MRI, both of which came back normal, but I am terrified of having another big seizure. I am worried about the following:1. Could stress or lack of sleep trigger seizures?,

2. Do I need to be on anti-seizure medication even if my tests are normal?

3. Am I allowed to drive?

4. What should I do if I feel another episode coming on?

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

A generalized seizure followed by shorter “staring” spells sounds concerning for epilepsy. Even though your MRI (magnetic resonance imaging) and EEG (electroencephalography) are normal, those tests can sometimes miss abnormalities between events. Stress, lack of sleep, alcohol, and missed meals are all well-known triggers that can lower the brain’s threshold for seizures, so avoiding these is very important.

Whether you need anti-seizure medication depends on several factors: the risk of recurrence is higher if you have already had more than one type of seizure-like episode (which you seem to be experiencing with the brief staring spells), if you have an abnormal neurological exam, or if risk factors are present. Many neurologists would recommend starting medication at this stage to reduce the chance of another major seizure.

As for driving, most countries and states require you to be seizure-free for a set period (commonly six to 12 months) before you can drive legally, so you should not drive until cleared by your neurologist for safety reasons.

If you feel another episode coming, try to sit or lie down somewhere safe, let those around you know what is happening, and avoid situations where losing awareness could put you in danger (like swimming alone, climbing, or operating machinery).

Close follow-up with your neurologist is important now, since starting medication could both lower your seizure risk and help you regain independence sooner.

I hope this helps.

Thank you.