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Seizure Threshold

Dr. Elizabeth Thiele

Elizabeth Thiele, MD, PhD
Epileptologist, MGH

This is a transcript of a video from the Growing Up with Epilepsy Web site. For more information visit

Dr. Elizabeth Thiele: We often use the words "seizure threshold" when we talk with a family and a child about having seizures. And if a child has had a seizure or a few seizures, then we talk that that child has a lower seizure threshold than the parents or than I do. I have not had any seizures, so if someone else has, then their threshold for having a seizure or for unusual electrical activity to start in their brain, leading to a seizure, is lower. Then when we talk about a lower seizure threshold, we talk with the family that if we put a child on the medication, it will effectively raise the threshold back up, making it less likely for that child to have a seizure. But, we also know that there are several things that can stress a child or stress an individual with epilepsy, making it, even in the presence of medicine, more likely for them to have a seizure. And this can be anything that stresses the child or their system. So for many people, common stresses or triggers are being overly tired, being very sick, having a high fever. But there are many triggers, many of which we don't understand. I have many families who honestly believe that dramatic changes in weather are associated with a change in their child's seizure frequency, and I believe that. We have other children who, certain smells or certain experiences, excitement, being upset can trigger their seizures. And I also believe that. We just don't understand how these different stresses lead to the child having a seizure episode.