Parkinson's and Seizures: The Connection

Parkinson's disease does not directly cause seizures, but people with Parkinson's have a higher risk of developing seizures than the general population. The seizure risk comes from several sources: the underlying brain changes that produce Parkinson's symptoms, the medications used to treat Parkinson's, and other neurological conditions that can occur alongside Parkinson's. This distinction matters because it changes how doctors approach treatment and what you should watch for.

The brain regions affected by Parkinson's — particularly areas that control movement and dopamine production — can make the brain more prone to abnormal electrical activity. Additionally, some Parkinson's medications, especially at higher doses, lower the seizure threshold, meaning the brain becomes more likely to have a seizure. If you or a family member has Parkinson's and experiences a seizure, the cause is not the disease itself but rather one of these related factors.

Key Takeaways

  • Parkinson's disease itself does not cause seizures, but people with Parkinson's have a higher seizure risk than people without the disease.
  • Parkinson's medications, particularly dopamine agonists and levodopa at high doses, can lower seizure threshold and increase seizure risk.
  • Other conditions that occur alongside Parkinson's — such as dementia, stroke, or brain injury — can be the actual cause of a seizure.
  • If a seizure occurs, tell your neurologist when ready so they can review your medications and investigate other possible causes.
  • Seizure medications exist and work alongside Parkinson's treatments, though some combinations require careful monitoring.

How Parkinson's Medications Increase Seizure Risk

The drugs that manage Parkinson's symptoms can make seizures more likely. Dopamine agonists — medications like pramipexole and ropinirole that mimic dopamine in the brain — have been associated with seizure risk, particularly at higher doses or in people with a personal or family history of seizures. Levodopa, the most commonly prescribed Parkinson's medication, also carries a seizure risk when doses are high or when the medication is combined with other drugs that affect brain chemistry.

The risk is not automatic. Most people taking these medications never have a seizure. However, the longer someone takes Parkinson's medication and the higher the dose, the greater the statistical risk becomes. If you have a personal or family history of seizures, your neurologist should know this before starting or adjusting Parkinson's medications, because they may choose a different drug or monitor you more closely.

Other Conditions That Cause Seizures in People With Parkinson's

People with Parkinson's often develop other neurological conditions that can trigger seizures independently. Parkinson's dementia — cognitive decline that occurs in the later stages of Parkinson's — increases seizure risk on its own. Stroke, brain injury, infection, or metabolic problems can also occur in people with Parkinson's and cause seizures. In these cases, the seizure is caused by the secondary condition, not by Parkinson's itself.

Additionally, some people have Parkinson's and a separate seizure disorder that developed before or after their Parkinson's diagnosis. These are two independent conditions that happen to coexist. When a seizure occurs, your neurologist will need to determine which factor — medication, dementia, another condition, or a separate seizure disorder — is responsible so that treatment can be targeted correctly.

What to Do If a Seizure Occurs

If someone with Parkinson's has a seizure, the when ready response is the same as for anyone: may support they are in a safe position, do not restrain them, and call emergency services if the seizure lasts longer than five minutes or if it is the first seizure they have had. After the seizure ends and emergency care has been provided, contact the neurologist who manages their Parkinson's care as soon as possible — ideally within 24 hours.

Bring a list of all current medications, including doses and when they were last changed. Write down what happened before, during, and after the seizure if you can — this information helps the neurologist determine the cause. The neurologist may order an EEG (a test that records brain electrical activity) or imaging to rule out stroke or other structural problems. They may also adjust Parkinson's medications or start a seizure medication depending on what they find.

Managing Both Parkinson's and Seizures

If someone with Parkinson's develops seizures, both conditions can be treated at the same time, though medication choices require care. Some seizure medications interact with Parkinson's drugs or can worsen Parkinson's symptoms. For example, certain older seizure medications can increase rigidity or worsen tremor. A neurologist experienced with both conditions will choose medications that control seizures without making Parkinson's symptoms harder to manage.

The goal is to find a balance where both the Parkinson's symptoms and the seizures are controlled as much as possible. This sometimes means adjusting Parkinson's medication doses, switching to a different Parkinson's drug, or choosing a seizure medication that has fewer interactions. Regular follow-up appointments become more important because the neurologist needs to monitor how the two sets of medications work together and adjust as needed.

Seizure Risk Factors in Parkinson's

Certain factors make seizures more likely in people with Parkinson's. Having a personal or family history of seizures or epilepsy increases risk. Advanced Parkinson's disease — particularly when dementia has developed — carries higher seizure risk than early-stage disease. High doses of Parkinson's medications, especially dopamine agonists, increase risk. Sudden changes in medication (stopping or reducing a dose too quickly) can also trigger seizures.

Infections, dehydration, sleep deprivation, and metabolic imbalances can lower seizure threshold in anyone, but people with Parkinson's may be more vulnerable. If someone with Parkinson's becomes ill or experiences a major change in their routine, their seizure risk may temporarily increase. This is another reason to maintain regular contact with their healthcare team and to report any significant changes in health or medication.

When to Contact a Neurologist

Contact the neurologist managing Parkinson's care if any of the following occur: a first-time seizure, a change in seizure pattern (more frequent, longer, or different in character), new episodes of loss of consciousness or confusion, falls that cannot be explained by Parkinson's symptoms alone, or any concern that medication changes may have triggered a problem. You do not need to wait for an emergency to report these — a phone call to the office can often be triaged to determine whether an urgent appointment is needed.

Also contact the neurologist if Parkinson's symptoms worsen after a seizure or after starting a seizure medication. Sometimes the new medication helps the seizures but makes tremor or rigidity worse, and the neurologist may need to rebalance the treatment plan. The relationship between Parkinson's and seizures is complex enough that ongoing communication with the specialist managing both conditions is essential.

Frequently Asked Questions

Does everyone with Parkinson's eventually have seizures?

No. Most people with Parkinson's never have a seizure. Seizure risk is higher than in the general population, but it remains uncommon. Risk increases with disease duration and with higher medication doses, but many people take Parkinson's medications for years without ever experiencing a seizure.

Can stopping Parkinson's medication prevent seizures?

Stopping Parkinson's medication could reduce seizure risk from that medication, but it would allow Parkinson's symptoms to return or worsen, which creates its own problems. The neurologist will not recommend stopping medication solely to prevent seizures. Instead, they may switch to a different medication with lower seizure risk or adjust the dose.

Are seizures in Parkinson's different from seizures in other conditions?

Seizures themselves look and feel the same regardless of cause, but the underlying reason for the seizure affects how it is treated. A seizure caused by a Parkinson's medication may be managed by adjusting that medication, while a seizure caused by dementia or stroke requires different treatment. The neurologist will investigate the cause to guide treatment decisions.

If someone with Parkinson's has a seizure, does it mean their disease is getting worse?

A seizure does not automatically mean Parkinson's is progressing faster. It may indicate that medication doses need adjustment, that another condition has developed, or that a separate seizure disorder has emerged. The seizure is a sign that something needs attention, but it is not necessarily a marker of disease progression on its own.

Can seizure medications make Parkinson's symptoms worse?

Some seizure medications can worsen Parkinson's symptoms, particularly older medications that affect dopamine. A neurologist will choose seizure medications carefully to avoid this problem. If a seizure medication does worsen Parkinson's symptoms, the neurologist may switch to a different seizure medication that has fewer interactions with Parkinson's treatment.