{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:01:55Z","timestamp":1790337715839,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"DOI":"10.7759\/cureus.116904","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:18:13Z","timestamp":1790335093000},"source":"Crossref","is-referenced-by-count":0,"title":["Why Seizures Break Through: Distinguishing Background Susceptibility From Proximal Precipitants in Patients With Epilepsy"],"prefix":"10.7759","author":[{"given":"Mahdi","family":"Fadel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Fadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataliah R","family":"Jwaida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burton","family":"Tabaac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18048","article-title":"Risk of breakthrough seizures depends on type and etiology of epilepsy","volume":"65","author":"Doerrfuss JI","year":"2024","unstructured":"Doerrfuss JI, Graf L, H\u00fcsing T, Holtkamp M, Ilyas-Feldmann M. Risk of breakthrough seizures depends on type and etiology of epilepsy. Epilepsia. 2024, 65:2589-98. 10.1111\/epi.18048","journal-title":"Epilepsia"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190035","article-title":"Breakthrough seizures-further analysis of the Standard versus New Antiepileptic Drugs (SANAD) study","volume":"12","author":"Bonnett LJ","year":"2017","unstructured":"Bonnett LJ, Powell GA, Tudur Smith C, Marson AG. Breakthrough seizures-further analysis of the Standard versus New Antiepileptic Drugs (SANAD) study. PLoS One. 2017, 12:e0190035. 10.1371\/journal.pone.0190035","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2004.11.003","article-title":"Which seizure-precipitating factors do patients with epilepsy most frequently report?","volume":"6","author":"Nakken KO","year":"2005","unstructured":"Nakken KO, Solaas MH, Kjeldsen MJ, Friis ML, Pellock JM, Corey LA. Which seizure-precipitating factors do patients with epilepsy most frequently report?. Epilepsy Behav. 2005, 6:85-9. 10.1016\/j.yebeh.2004.11.003","journal-title":"Epilepsy Behav"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03620.x","article-title":"Provoked and reflex seizures: surprising or common?","volume":"53 Suppl 4","author":"Kasteleijn-Nolst Trenit\u00e9 DG","year":"2012","unstructured":"Kasteleijn-Nolst Trenit\u00e9 DG. Provoked and reflex seizures: surprising or common?. Epilepsia. 2012, 53 Suppl 4:105-13. 10.1111\/j.1528-1167.2012.03620.x","journal-title":"Epilepsia"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.05.036","article-title":"Dealing with the storm: an overview of seizure precipitants and spontaneous seizure worsening in drug-resistant epilepsy","volume":"97","author":"Bartolini E","year":"2019","unstructured":"Bartolini E, Sander JW. Dealing with the storm: an overview of seizure precipitants and spontaneous seizure worsening in drug-resistant epilepsy. Epilepsy Behav. 2019, 97:212-8. 10.1016\/j.yebeh.2019.05.036","journal-title":"Epilepsy Behav"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02285.x","article-title":"Recommendation for a definition of acute symptomatic seizure","volume":"51","author":"Beghi E","year":"2010","unstructured":"Beghi E, Carpio A, Forsgren L, et al.. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010, 51:671-5. 10.1111\/j.1528-1167.2009.02285.x","journal-title":"Epilepsia"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012944","article-title":"Antiseizure medication withdrawal in seizure-free patients: practice advisory update summary: report of the AAN Guideline Subcommittee","volume":"97","author":"Gloss D","year":"2021","unstructured":"Gloss D, Pargeon K, Pack A, et al.. Antiseizure medication withdrawal in seizure-free patients: practice advisory update summary: report of the AAN Guideline Subcommittee. Neurology. 2021, 97:1072-81. 10.1212\/WNL.0000000000012944","journal-title":"Neurology"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.14581\/jer.23003","article-title":"The frequency and precipitating factors for breakthrough seizures in children with epilepsy","volume":"13","author":"Aldosari AN","year":"2023","unstructured":"Aldosari AN, Alghamdi A, Alharthi A, Albuhayri A, Ghurab S, Alghamdi M, Aldosari M. The frequency and precipitating factors for breakthrough seizures in children with epilepsy. J Epilepsy Res. 2023, 13:13-8. 10.14581\/jer.23003","journal-title":"J Epilepsy Res"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1062_24","article-title":"Determination of precipitating factors for breakthrough seizures among patients with epilepsy in a tribal area of Jharkhand: a retrospective study","volume":"14","author":"Prasad P","year":"2025","unstructured":"Prasad P, Verma V. Determination of precipitating factors for breakthrough seizures among patients with epilepsy in a tribal area of Jharkhand: a retrospective study. J Family Med Prim Care. 2025, 14:2266-72. 10.4103\/jfmpc.jfmpc_1062_24","journal-title":"J Family Med Prim Care"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1499-1654.2000.001534.x","article-title":"Distribution of seizure precipitants among epilepsy syndromes","volume":"41","author":"Frucht MM","year":"2000","unstructured":"Frucht MM, Quigg M, Schwaner C, Fountain NB. Distribution of seizure precipitants among epilepsy syndromes. Epilepsia. 2000, 41:1534-9. 10.1111\/j.1499-1654.2000.001534.x","journal-title":"Epilepsia"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12801","article-title":"Nonadherence to treatment causing acute hospitalizations in people with epilepsy: an observational, prospective study","volume":"55","author":"Samsonsen C","year":"2014","unstructured":"Samsonsen C, Reimers A, Br\u00e5then G, Helde G, Brodtkorb E. Nonadherence to treatment causing acute hospitalizations in people with epilepsy: an observational, prospective study. Epilepsia. 2014, 55:e125-8. 10.1111\/epi.12801","journal-title":"Epilepsia"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000709","article-title":"Optimizing management of medically responsive epilepsy","volume":"25","author":"Bauer D","year":"2019","unstructured":"Bauer D, Quigg M. Optimizing management of medically responsive epilepsy. Continuum (Minneap Minn). 2019, 25:343-61. 10.1212\/CON.0000000000000709","journal-title":"Continuum (Minneap Minn)"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25710","article-title":"Insufficient sleep, electroencephalogram activation, and seizure risk: re-evaluating the evidence","volume":"87","author":"Rossi KC","year":"2020","unstructured":"Rossi KC, Joe J, Makhija M, Goldenholz DM. Insufficient sleep, electroencephalogram activation, and seizure risk: re-evaluating the evidence. Ann Neurol. 2020, 87:798-806. 10.1002\/ana.25710","journal-title":"Ann Neurol"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2016.09.014","article-title":"The impact of sleep loss on the facilitation of seizures: a prospective case-crossover study","volume":"127","author":"Samsonsen C","year":"2016","unstructured":"Samsonsen C, Sand T, Br\u00e5then G, Helde G, Brodtkorb E. The impact of sleep loss on the facilitation of seizures: a prospective case-crossover study. Epilepsy Res. 2016, 127:260-6. 10.1016\/j.eplepsyres.2016.09.014","journal-title":"Epilepsy Res"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13741","article-title":"Stress is associated with an increased risk of recurrent seizures in adults","volume":"58","author":"Baldin E","year":"2017","unstructured":"Baldin E, Hauser WA, Pack A, Hesdorffer DC. Stress is associated with an increased risk of recurrent seizures in adults. Epilepsia. 2017, 58:1037-46. 10.1111\/epi.13741","journal-title":"Epilepsia"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2025.106065","article-title":"Perceived stress in adults with epilepsy: a systematic review","volume":"170","author":"Catal\u00e1n-Aguilar J","year":"2025","unstructured":"Catal\u00e1n-Aguilar J, Gonz\u00e1lez-Bono E, Cano-L\u00f3pez I. Perceived stress in adults with epilepsy: a systematic review. Neurosci Biobehav Rev. 2025, 170:106065. 10.1016\/j.neubiorev.2025.106065","journal-title":"Neurosci Biobehav Rev"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2016.12.009","article-title":"Stress as a seizure precipitant: identification, associated factors, and treatment options","volume":"44","author":"McKee HR","year":"2017","unstructured":"McKee HR, Privitera MD. Stress as a seizure precipitant: identification, associated factors, and treatment options. Seizure. 2017, 44:21-6. 10.1016\/j.seizure.2016.12.009","journal-title":"Seizure"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00401","article-title":"Alcohol use and alcohol-related seizures in patients with epilepsy","volume":"9","author":"Hamerle M","year":"2018","unstructured":"Hamerle M, Ghaeni L, Kowski A, Weissinger F, Holtkamp M. Alcohol use and alcohol-related seizures in patients with epilepsy. Front Neurol. 2018, 9:401. 10.3389\/fneur.2018.00401","journal-title":"Front Neurol"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2018.04.007","article-title":"The seizure precipitating effect of alcohol: a prospective observational cross-over study","volume":"143","author":"Samsonsen C","year":"2018","unstructured":"Samsonsen C, Myklebust H, Strindler T, Br\u00e5then G, Helde G, Brodtkorb E. The seizure precipitating effect of alcohol: a prospective observational cross-over study. Epilepsy Res. 2018, 143:82-9. 10.1016\/j.eplepsyres.2018.04.007","journal-title":"Epilepsy Res"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.5487","article-title":"Antiseizure medication concentrations during pregnancy: results from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study","volume":"79","author":"Pennell PB","year":"2022","unstructured":"Pennell PB, Karanam A, Meador KJ, et al.. Antiseizure medication concentrations during pregnancy: results from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study. JAMA Neurol. 2022, 79:370-9. 10.1001\/jamaneurol.2021.5487","journal-title":"JAMA Neurol"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008663","article-title":"Changes in seizure frequency and antiepileptic therapy during pregnancy","volume":"383","author":"Pennell PB","year":"2020","unstructured":"Pennell PB, French JA, May RC, et al.. Changes in seizure frequency and antiepileptic therapy during pregnancy. N Engl J Med. 2020, 383:2547-56. 10.1056\/NEJMoa2008663","journal-title":"N Engl J Med"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109339","article-title":"Disentangling the cascade of seizure precipitants: a prospective observational study","volume":"145","author":"Samsonsen C","year":"2023","unstructured":"Samsonsen C, Mestvedthagen G, Uglem M, Brodtkorb E. Disentangling the cascade of seizure precipitants: a prospective observational study. Epilepsy Behav. 2023, 145:109339. 10.1016\/j.yebeh.2023.109339","journal-title":"Epilepsy Behav"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.5370","article-title":"Seizure cycles in focal epilepsy","volume":"78","author":"Leguia MG","year":"2021","unstructured":"Leguia MG, Andrzejak RG, Rummel C, et al.. Seizure cycles in focal epilepsy. JAMA Neurol. 2021, 78:454-63. 10.1001\/jamaneurol.2020.5370","journal-title":"JAMA Neurol"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-02577-y","article-title":"Multi-day rhythms modulate seizure risk in epilepsy","volume":"9","author":"Baud MO","year":"2018","unstructured":"Baud MO, Kleen JK, Mirro EA, Andrechak JC, King-Stephens D, Chang EF, Rao VR. Multi-day rhythms modulate seizure risk in epilepsy. Nat Commun. 2018, 9:88. 10.1038\/s41467-017-02577-y","journal-title":"Nat Commun"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/536426-why-seizures-break-through-distinguishing-background-susceptibility-from-proximal-precipitants-in-patients-with-epilepsy","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:18:14Z","timestamp":1790335094000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/536426-why-seizures-break-through-distinguishing-background-susceptibility-from-proximal-precipitants-in-patients-with-epilepsy"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":24,"URL":"https:\/\/doi.org\/10.7759\/cureus.116904","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,25]]}}}