Seizure triggers

Some people are particularly sensitive to increased seizures when they miss a dose of their antiepileptic medication. The longer the break between doses, the lower your blood levels will go and the greater your chance of having a seizure. If you take your medication erratically or you suddenly stop taking all medication, you may trigger a severe and prolonged seizure or a cluster of seizures that will require hospitalisation.

Stress is a normal part of life. In fact, we need a certain amount to motivate ourselves and to stay healthy. Extreme stress, however, may lower your seizure threshold and trigger seizures. It is important to learn to recognise the signs and symptoms of harmful levels of stress and to employ strategies that you find helpful in reducing it. Relaxation techniques such as yoga, breathing exercises or aerobic exercise may help.

This is a common trigger factor. Everyone differs in the amount of sleep they need, however, avoid extreme fluctuations in the time you go to bed and make sure you get enough sleep to feel rested.

While some people with epilepsy have seizures that are very sensitive to even small amounts of alcohol, most can enjoy an occasional beer or two or a glass of wine with dinner. The key is to ensure the principle of moderation. Moderate alcohol intake is having no more than two standard drinks in a day and preferably not every day.

Alcohol and antiepileptic medications (AEDs) interact in specific ways. AEDs can make you more sensitive to the sedating effects of alcohol while alcohol reduces the effectiveness of AEDs making seizures more likely. Excessive drinking can result in poor seizure control due to late nights, missed meals, or forgotten doses, while ‘hangover’ seizures are likely to occur as the alcohol level in the blood falls. Ask your doctor about the effects of drinking alcohol with the medication you have been prescribed.

Coffee, tea and cola drinks contain caffeine. For some people, caffeine can trigger seizures while others are susceptible to having seizures if they miss meals and have a low blood sugar level. Regular meals and eating immediately after getting out of bed in the morning will protect you against large swings in blood sugar levels.

Children are particularly likely to have more seizures when they develop infections such as tonsillitis and earache. This is possibly due to high temperature and usually eases within a few days. Allergies may provoke seizures in some people with epilepsy. Diarrhoea and vomiting can trigger seizures because they can prevent your body from absorbing your antiepileptic medication.

Some women find that they have more seizures just before or during their menstrual period. This may be caused by a combination of factors such as increased fluid retention, changes in hormonal levels and variation in levels of antiepileptic medications in the blood. A significant increase in seizure activity at this time is known as catamenial epilepsy. If you notice this happening, discuss it with your doctor. By altering your dose of antiepileptic medication or introducing another medication, your doctor may be able to control or ease the problem.

Withdrawal from sedative and hypnotic drugs, including minor tranquillizers, sleeping pills and illegal drugs can be a problem, as can combining these drugs with antiepileptic medication. It is essential to tell your doctor about all the medications you take. This includes disclosing any over the counter herbal or vitamin supplements you consume.

Photosensitive epilepsy is rare, affecting only a small number of people with epilepsy. For people who experience this, seizures are triggered by sensory stimuli such as flickering sunlight, strobe lights or flickering television. Simple preventative measures can be taken to decrease seizures triggered this way such wearing wrap-around sunglasses to reduce glare and covering one eye to reduce the effects of flickering or flashing light. Most computer monitors do not present a problem, however, if you are sensitive to screen flicker, try using a non-interlaced monitor and take regular breaks.

Other possible triggers are unique to certain people. For example, some report that unusual stimuli such as strong smells like petrol, bleach or glue can trigger seizures.

You can print the above information from the fact sheet below.

Seizure diaries can help to identify these triggers and provide a good picture of seizure patterns. Some people may not become aware of their triggers until they keep a seizure diary for some time. 

A seizure diary needs to include:  

• Date and time of seizures  
• If you were asleep or awake  
• Description or type of seizure  
• What happened before, during and after the seizure, if known 
• Medication taken or missed that day, including medication for other conditions 
• Any possible seizure triggers  
• General health and energy level leading up to the seizures  
• Menstrual cycle for women