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The seizure threshold is a tipping point in a person's brain activity where a seizure will develop. People with seizure disorders tend to have a low seizure threshold, and this can be exacerbated over time, as seizures can have the effect of exciting the brain and increasing the chances of having another seizure. Understanding the role of baseline brain activity and trigger points for seizures is important for the successful management of seizure disorders. Many individuals may go through their lives without having seizures because their thresholds are high or normal.
During a seizure, the brain experiences uncontrolled electrical activity, with neurons firing repeatedly and at random. Depending on the area of the brain involved, the patient can experience a variety of symptoms over the course of the seizure, including muscle jerks and confusion. Seizures occur when excitatory activity in the brain, with neurons firing neurotransmitters to activate various neurons, rises rapidly and exceeds inhibitory activity, where neurotransmitters designed to limit brain activity are fired.
In a person with a low seizure threshold, brain activity is naturally high, and it does not take much excitement to push the patient's brain into a seizure. Certain medications are linked with a lower seizure threshold and patients can also be triggered by stimuli like flashing lights and smells, stress, or hypoglycemia. These patients will experience seizures in response to stimuli that people with a normal or high threshold can usually safety interact with.
Patients with epilepsy may be given medications to increase inhibitory activity in their brains with the goal of raising the seizure threshold and making seizures less likely. In addition, they can avoid exposures known to increase brain activity and trigger seizures, such as not taking certain medications or avoiding known triggers like specific scents. This combination of medication and avoidance can help a patient reduce or stop seizure activity.
When a patient first starts to develop signs of a seizure disorder, doctors will usually recommend extensive screening to learn more about what is happening inside the brain and to identify specific causes of a patient's seizures. This information is utilized in the development of a detailed and comprehensive treatment plan. The plan can be adjusted over time to address changes in the patient's condition and to provide patients with access to the latest in treatment and management of neurological conditions. Patients may be seen by a seizure specialist or a general neurologist, depending on the nature of the case.