Seizures are sudden, temporary disruptions of brain activity caused by abnormal electrical signals. While a single seizure can occur due to temporary factors, recurring seizures are characteristic of epilepsy. The possibility of achieving seizure remission, often described as “growing out of” seizures, is a significant question for many individuals and their families.
Seizure Remission in Childhood
Many children diagnosed with epilepsy have a favorable outlook for seizure remission as they grow older, particularly in specific childhood epilepsy syndromes where brain development plays a significant role. For instance, Benign Rolandic Epilepsy (BRE), one of the most common childhood epilepsy syndromes, typically sees seizures stop by age 15, with remission rates as high as 95%.
Another example is Childhood Absence Epilepsy (CAE), which begins between ages 4 and 10 and frequently resolves by mid-adolescence. Around two-thirds to 90% of children with CAE may achieve remission, often allowing them to discontinue medication. Overall, about 60-70% of children with epilepsy may achieve complete remission over time.
Seizure Remission in Adulthood
Seizure remission can also occur in adults, though it’s not due to brain maturation as in childhood. Remission can still be achieved, especially if seizures are newly diagnosed or well-controlled with medication. For adults with long-standing, difficult-to-treat epilepsy, studies indicate an annual remission probability of approximately 4-5%.
Many individuals with newly diagnosed epilepsy can achieve remission. For those who respond to initial medication, 80% to 90% may attain a two-year remission within five years. If a clear underlying cause for seizures is identified and effectively treated, the likelihood of remission can be higher. While adult remission may be less common than in certain childhood syndromes, it remains a possibility for many.
Factors Affecting Seizure Remission
Several factors influence the likelihood of achieving seizure remission across all age groups. The underlying cause of the seizures plays a role, with conditions like genetic epilepsies or those without an identifiable structural cause often having a better prognosis. The specific type of seizure and the diagnosed epilepsy syndrome are also important indicators. For example, generalized epilepsies tend to have better remission rates than some focal epilepsies.
Response to anti-seizure medication and consistent adherence to treatment are significant predictors of remission. Patients who achieve early seizure control with medication have a higher chance of long-term remission. Conversely, a history of status epilepticus, older age at seizure onset, or the presence of other neurological abnormalities can reduce the probability of remission. The number of failed medication therapies also impacts future remission prospects.
Living with Ongoing Seizures
For individuals whose seizures do not go into remission, effective management becomes the primary focus. Anti-seizure medications are the most common and often successful treatment, helping about 70% of people achieve seizure control. For those with drug-resistant epilepsy, other therapeutic options are available.
These options include surgical interventions to remove the seizure-generating area of the brain, or neuromodulation techniques such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS). Dietary therapies, such as the ketogenic diet, can also be beneficial, particularly for children with specific types of epilepsy. Regular medical follow-up, lifestyle adjustments, and strong support systems are important for managing ongoing seizures.