Known Epilepsy with Breakthrough Seizure

The approach to a breakthrough seizure is to first characterize the episode and determine what the precipitating factor was. This will help guide treatment. If it is due to medication non-compliance, patients are restarted on their home meds +/- a loading dose.

Last updated 3/20/2026

Description of current episode

Description of seizure(s) (Number, duration, and type of breakthrough seizures)

Patient report

Witness report

Estimated duration

Where did the seizure occur

Injury sustained

New neurological symptoms

Seizure was similar to prior seizures

Tongue biting

Bowel incontinence

Bladder incontinence

Triggers for breakthrough seizure

Epilepsy history

Epilepsy syndrome (if known)

Estimated baseline seizure frequency

Clear precipitant for breakthrough seizures in the past?

History of psychogenic non epileptic events

Prior head imaging results (MRI brain, head CT, PET scan of brain)

Prior EEG (in-patient, out-patient, ambulatory, epilepsy monitoring unit) results

Current anti-seizure medication(s) (name, dosage, frequency, formulation)

Previous anti-seizure medication(s) tried, reason for discontinuation

Seizure rescue plan

Description of current episode

Triggers for breakthrough seizure

Epilepsy history

Counseling