Breakthrough Seizures In Known Epileptics

When seizures recur in known epileptics, something has occurred to alter the balance of the excitation-inhibition complex, causing the seizure threshold to be lowered. Complete seizure control is not always possible. A child with mental retardation, cerebral palsy, and complex partial seizures with or without secondary generalization is most likely to have recurring seizures. Tonic-clonic (grand mal) seizures are the most dramatic and often lead to emergency treatment. The usual causes of seizure breakthrough can be summarized as follows: lowered anticonvulsant blood levels, change in habits, complicating factors of epilepsy management, and progression of the underlying cause. Superimposed head trauma may also precipitate seizures. And, finally, an unprovoked episode of seizures may occur in a well child with adequate levels of anticonvulsants.

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