Seizures are sudden disruptions in the brain’s normal electrical activity that can cause changes in behavior, movements, and feelings. The length of time someone can live with recurrent seizures depends on many factors, including the type and cause of the seizures and how well they can be controlled with treatment.
What impacts life expectancy with seizures?
Some of the key factors that influence life expectancy for those living with seizures include:
- Seizure type – Some seizure types, like generalized tonic-clonic seizures, carry a higher risk of injury or sudden unexpected death.
- Seizure frequency – Frequent seizures, especially if uncontrolled, can increase mortality risk.
- Seizure control – Achieving seizure freedom or reducing seizure frequency with medication or other treatments is linked to better outcomes.
- Underlying cause – Life expectancy may be impacted by conditions that cause the seizures, like brain tumors, stroke, or neurodegenerative disease.
- Adherence to treatment – Consistently taking prescribed medications and following the treatment plan is crucial.
- Other health conditions – Co-existing medical issues like heart disease can also affect life expectancy.
Let’s take a closer look at how these key factors relate to life expectancy with seizures.
Seizure Type
The form of seizures someone experiences can make a difference in mortality risk. Some types are more dangerous than others:
- Generalized tonic-clonic seizures – Also known as grand mal seizures, these involve loss of consciousness and violent muscle contractions. They carry the highest risk of injury or sudden, unexpected death.
- Focal onset impaired awareness seizures – Formerly called complex partial seizures, these start in one area of the brain but can impair consciousness. They may increase risks from falls or accidents.
- Absence seizures – These involve brief periods of staring or loss of awareness and are less likely to result in injury. However, they can interfere with daily activities if frequent.
Tonic-clonic and focal impaired awareness seizures are most closely tied to higher mortality rates if uncontrolled. Fortunately, many people with these seizure types can achieve good control with medications.
Seizure Frequency
In general, the more often someone has seizures, the higher their risk of complications and reduced life expectancy. Some key points on seizure frequency include:
- People with active epilepsy who have one or more seizures per month have a mortality risk nearly 2-3 times higher than the general population.
- Frequent generalized tonic-clonic seizures (more than one per month) are linked to a high risk of sudden unexpected death in epilepsy (SUDEP).
- Even occasional tonic-clonic seizures may increase SUDEP risk.
- The strongest predictor of future seizures is having had past seizures. Recurrent seizures often indicate uncontrolled epilepsy.
Controlling seizure frequency through medications, surgery, or devices like vagus nerve stimulation can help reduce risks associated with recurrent seizures.
Seizure Control and Remission
Achieving seizure control, meaning a complete lack of seizures, is associated with a better outlook. Some key statistics on seizure control and life expectancy:
- Up to 70% of people with epilepsy can become seizure-free with appropriate treatment.
- After being seizure-free for 4-5 years on medication, many people may be able to taper off medication and remain in remission.
- Patients who achieve seizure remission have life expectancies similar to the general population.
- Even reducing seizure frequency may lower risks associated with ongoing seizures.
Gaining seizure control takes time to find the right treatment, but significantly improves quality of life and long-term prognosis.
Underlying Cause
The underlying cause of seizures can impact life expectancy in some cases. For example:
- Seizures due to irreversible brain conditions like stroke, tumors, infections, or neurodegenerative disease tend to have a worse outlook than seizures from reversible causes.
- Seizures resulting from metabolic disturbances like electrolyte imbalances may completely resolve if the metabolic problem is corrected.
- Seizures stemming from genetic conditions like autosomal dominant nocturnal frontal lobe epilepsy may respond very well to treatment and carry a normal life expectancy.
When seizures result from progressive illness, the prognosis depends significantly on the expected course of that illness. Reversible causes may allow for normal longevity if the seizures can be well-controlled.
Treatment Adherence
Taking anti-seizure medications or following other treatments as prescribed is crucial. Unfortunately:
- Around 60% of people with epilepsy are non-adherent at some point.
- Even occasional missed doses can trigger breakthrough seizures.
- Non-adherence is associated with increased risk of injuries, fractures, emergency department visits, and premature death.
- Common barriers to adherence include side effects, cost, memory issues, and lack of support.
Working closely with one’s healthcare team to maintain adherence is key to achieving optimal seizure control and associated quality of life benefits.
Other Health Conditions
People with epilepsy are at higher risk of other conditions that may impact mortality, like:
- Depression – Depression affects up to 60% of people with epilepsy and may increase suicide risk.
- Cardiovascular disease – Some anti-seizure medications can increase risk factors like high cholesterol or weight gain.
- Falls and fractures – Seizures may result in dangerous falls, especially in older adults.
- Status epilepticus – Prolonged seizures lasting more than 5 minutes may lead to brain damage or death if untreated.
Managing co-existing medical conditions along with epilepsy care is an important part of optimizing life expectancy.
Key Takeaways
Some key points on life expectancy with seizure disorders:
- Many factors affect the prognosis, especially achieving seizure control and reducing frequency.
- With appropriate treatment, most people with epilepsy can expect a near-normal life expectancy.
- Seizure freedom for 4-5 years enables many to stop medications and remain seizure-free.
- Adhering to prescribed treatments is extremely important for ongoing seizure control.
- Even individuals with drug-resistant epilepsy may benefit from options like surgery, devices, or diet therapy.
- Addressing co-existing health conditions along with epilepsy treatment is recommended.
- Working closely with an epilepsy specialist provides the greatest chance of optimizing seizure control and longevity.
Life Expectancy by Type of Epilepsy
Life expectancy can vary based on the specific epilepsy syndrome. Some examples:
| Type of Epilepsy | Life Expectancy |
|---|---|
| Childhood absence epilepsy | Normal life expectancy if seizures well-controlled |
| Juvenile myoclonic epilepsy | Normal life expectancy with treatment adherence |
| Temporal lobe epilepsy | Normal life expectancy, but increased SUDEP risk if uncontrolled |
| West syndrome (infantile spasms) | Dependent on underlying cause; often developmental impairment |
| Lennox-Gastaut syndrome | Below average life expectancy; high risk of status epilepticus |
| Dravet syndrome | Below average life expectancy; frequent seizures |
| Epilepsy from stroke | Below average life expectancy due to stroke complications |
As evidenced, some pediatric epilepsy syndromes have a good prognosis if seizures are well-managed. Severe childhood-onset epilepsies have a less favorable outlook but treatment can still improve quality of life.
Conclusion
A diagnosis of epilepsy does not preclude one from living a long and fulfilling life. With the right treatment plan and adherence, most people with epilepsy have a normal or near-normal life expectancy. Even cases of drug-resistant epilepsy have options like surgery, devices, and diet therapy to help reduce seizures. Working closely with an experienced epilepsy specialist gives the best chance for becoming seizure-free and minimizing risks associated with ongoing seizures. While some severe epilepsy syndromes may reduce lifespan, quality of life can still be improved with comprehensive treatment. With the advancing care for epilepsy in recent decades, including newer medications and technologies, the prognosis for living well with seizures continues to improve.