Parkinson's can increase seizure risk, but seizures are not a direct symptom of the disease itself

Seizures are not a typical feature of Parkinson's disease. However, people with Parkinson's do have a higher risk of developing seizures than the general population. This increased risk comes from several sources: the underlying brain changes that cause Parkinson's, the medications used to treat it, and other conditions that often occur alongside Parkinson's. Understanding this distinction matters because it changes how you and your doctor approach the problem.

If you or someone you care for has Parkinson's and experiences a seizure, that seizure needs medical attention and investigation. It is not automatically "caused by" Parkinson's in the way tremor or rigidity is. Instead, a seizure signals that something else is happening in the brain that requires diagnosis and treatment.

Key Takeaways

  • Seizures are not a standard symptom of Parkinson's disease, but people with Parkinson's have a higher seizure risk than those without it.
  • Parkinson's medications, particularly dopamine agonists and levodopa at high doses, can lower the seizure threshold and trigger seizures in some people.
  • Dementia, stroke, brain injury, and other conditions that co-occur with Parkinson's can cause seizures independently of the Parkinson's itself.
  • Any new seizure in someone with Parkinson's requires evaluation by a neurologist to identify the actual cause and adjust treatment if needed.

How Parkinson's medications can increase seizure risk

Dopamine agonists — medications like pramipexole, ropinirole, and rotigotine — are known to lower the seizure threshold. This means they make the brain more prone to electrical misfiring that triggers a seizure. The risk is real but not common; most people taking these drugs do not have seizures. However, the risk is higher in people who already have factors that make seizures more likely, such as a history of head injury, stroke, or brain lesions.

Levodopa, the most effective Parkinson's medication, can also increase seizure risk, especially at higher doses. The relationship is dose-dependent: the more levodopa someone takes, the greater the risk. This does not mean people should stop taking levodopa — the benefit in controlling Parkinson's symptoms usually outweighs the seizure risk. But it does mean your neurologist needs to know about any seizures so they can weigh whether a dose adjustment or medication change is necessary.

Other Parkinson's medications, including MAO inhibitors and COMT inhibitors, carry lower seizure risk but are not risk-free. If seizures develop after starting or increasing a Parkinson's medication, tell your neurologist immediately. They may switch you to a different drug or adjust the dose.

Conditions that cause seizures in people with Parkinson's

Parkinson's often occurs alongside other brain conditions that independently cause seizures. Parkinson's dementia and Lewy body dementia both increase seizure risk. Dementia changes the brain's electrical activity and can trigger seizures even in people without Parkinson's. If someone has both Parkinson's and dementia, the seizure risk is higher than either condition alone.

Stroke is another common co-occurring condition. A stroke damages brain tissue and creates scar tissue that can act as a seizure focus — a spot where electrical activity misfires. People with Parkinson's have a higher stroke risk due to shared vascular risk factors and sometimes due to medication side effects. A seizure after a stroke is a sign of post-stroke epilepsy, not Parkinson's-related seizure.

Head injury, brain tumors, infections, and metabolic problems can all cause seizures in people with Parkinson's. These are separate medical events that happen to occur in someone who also has Parkinson's. The seizure itself requires its own diagnosis and treatment plan.

What happens if a seizure occurs

If someone with Parkinson's has a seizure, the immediate response is the same as for anyone: keep them safe during the seizure, note how long it lasts, and call emergency services if it lasts longer than five minutes or if multiple seizures occur in a row. After the seizure, medical evaluation is essential.

Your neurologist will want to know: When did the seizure happen? What did it look like? Had the Parkinson's medications changed recently? Are there any new symptoms or changes in thinking, vision, or balance? They may order an EEG (electroencephalogram) to record brain activity, an MRI to look for structural changes, or blood tests to check medication levels and metabolic function. These tests help identify whether the seizure came from a medication side effect, a new brain condition, or something else entirely.

Once the cause is identified, treatment can be targeted. If a medication is responsible, the dose may be lowered or the drug switched. If dementia or stroke is the cause, seizure prevention medication (an anticonvulsant) may be started. The goal is to control both the seizure risk and the Parkinson's symptoms.

Seizure prevention medication and Parkinson's interactions

If seizures do occur and a doctor prescribes an anticonvulsant, there is an important consideration: some seizure medications interact with Parkinson's drugs or worsen Parkinson's symptoms. Phenytoin, an older anticonvulsant, can make Parkinson's symptoms worse and is generally avoided. Levetiracetam and lamotrigine are often preferred because they have fewer interactions with Parkinson's medications.

Your neurologist and the doctor prescribing the seizure medication need to communicate about all the drugs you are taking. This is not a situation where you can simply add a seizure medication without checking for conflicts. The goal is to find an anticonvulsant that prevents seizures without destabilizing Parkinson's control.

When to contact your neurologist about seizure concerns

Contact your neurologist if you experience a seizure, even a brief one. Also reach out if you notice new symptoms that might suggest seizure activity: unexplained falls, brief episodes of staring or unresponsiveness, jerking movements, or periods of confusion that come and go. These could be seizures or could be something else, but they warrant evaluation.

If you are starting a new Parkinson's medication or increasing a dose and you have concerns about seizure risk, you can discuss this with your neurologist before the change. They can tell you whether the specific medication carries meaningful seizure risk for you based on your medical history. This conversation is especially important if you have had seizures in the past, have a family history of seizures, or have had a stroke or head injury.

Living with Parkinson's and seizure risk

The presence of Parkinson's does not automatically mean seizures will develop. Many people with Parkinson's never have a seizure. However, awareness of the increased risk helps you recognize warning signs early. Keep a record of any unusual episodes — falls, brief periods of confusion, jerking movements — and share this with your neurologist at appointments.

If seizures do occur, they are treatable. The key is identifying the cause so the right treatment can be started. This might mean adjusting Parkinson's medications, starting seizure prevention medication, or treating an underlying condition like dementia or stroke. Your neurologist can help coordinate this care.

Frequently Asked Questions

Are seizures a symptom of Parkinson's disease?

No. Seizures are not a standard symptom of Parkinson's. However, people with Parkinson's have a higher seizure risk than the general population due to medication effects, brain changes, and other conditions that often co-occur with Parkinson's. A seizure in someone with Parkinson's signals that something else needs investigation.

Can levodopa cause seizures?

Levodopa can increase seizure risk, especially at higher doses. The benefit of levodopa in controlling Parkinson's symptoms usually outweighs this risk for most people. If seizures develop, your neurologist may adjust the dose or consider alternative medications, but stopping levodopa abruptly is dangerous and should never be done without medical guidance.

What should I do if someone with Parkinson's has a seizure?

Keep them safe during the seizure by moving nearby objects away and placing something soft under their head. Do not restrain them or put anything in their mouth. Call emergency services if the seizure lasts longer than five minutes or if multiple seizures occur. After the seizure, seek medical evaluation to identify the cause.

Will seizure medication make my Parkinson's worse?

Some seizure medications can worsen Parkinson's symptoms, but others do not. Levetiracetam and lamotrigine are generally safer choices for people with Parkinson's. Your neurologist and the doctor prescribing the seizure medication should discuss your full medication list to find an option that works for both conditions.

Is there a way to prevent seizures if I have Parkinson's?

There is no may provide prevention, but you can reduce risk by taking Parkinson's medications exactly as prescribed and reporting any dose changes or new symptoms to your neurologist. Treating other conditions that increase seizure risk — such as managing blood pressure to prevent stroke — also helps. Regular neurological monitoring allows early detection if seizure risk increases.