What could cause a first-time seizure in a woman?

Question

Hello doctor,

I am a 30-year-old woman. Last week, I suddenly fell and started shaking uncontrollably, and I did not remember anything for a few minutes. The emergency room doctor said it was probably a seizure, but I am terrified because it came out of nowhere. Can you explain in simple, layman’s terms how seizures happen in someone who has never had them before?

I have been stressed, not sleeping well, and recently started a new antidepressant. Could that be related? I am also worried about driving, pregnancy safety, and long-term medications. Is it necessary to start anti-seizure medicine immediately, or should I wait for the EEG and MRI first? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand how you must be feeling about this.

What you experienced sounds like a first-time seizure, and it is completely understandable to feel frightened. A seizure happens when there is a sudden burst of abnormal electrical activity in the brain. This can cause a person to lose consciousness (faint or black out), fall, or shake uncontrollably for a short time.

In people who have never had seizures before, several things can trigger this abnormal brain activity. Sometimes it occurs due to sleep deprivation (not getting enough sleep), high stress, or certain medicines that affect brain chemicals. Since you recently started a new antidepressant, it is possible that it slightly lowered your seizure threshold (the brain’s resistance to seizures), making the brain more sensitive. Other possible causes include infection, electrolyte imbalance (too little or too much sodium, potassium, or calcium in the blood), or, in rare cases, structural changes in the brain such as tumors or scar tissue. These can be checked with an MRI (magnetic resonance imaging scan), which shows detailed pictures of the brain.

After a first seizure, doctors usually recommend an EEG (electroencephalogram, a test that records the brain’s electrical activity) and an MRI of the brain to look for any structural or physical problems. These tests help determine whether you need to start long-term anti-seizure medication. If both tests are normal and the seizure seems to have been triggered by lack of sleep, stress, or medication, doctors may choose to wait and monitor before starting treatment. However, if either test shows an abnormality, starting medication early can help prevent another seizure.

Until your evaluation is complete, it is safest not to drive. Most countries and states have laws that require a person to be seizure-free for a certain period before driving again. Regarding pregnancy, many women with seizures have healthy pregnancies. Some anti-seizure medications are considered safe when prescribed and monitored carefully by your doctor.

Your seizure may have been a one-time event, possibly linked to stress, sleep loss, or your new antidepressant. EEG and MRI are important before making any decisions about long-term treatment. Try to maintain good sleep habits, avoid alcohol, manage stress, and review your medications with your doctor. Most people who have a first seizure recover fully and continue to live normal, healthy lives once the cause is found and managed.

I hope this helps you.

Kindly revert if there are any queries.

Thank you.