Some people with epilepsy find that certain factors may induce seizures. You may not become aware of your trigger factors unless you keep a seizure diary for a period of time. The following list of trigger factors is a guide but it is by no means an exhaustive list.
While some people with epilepsy have seizures that are very sensitive to even small amounts of alcohol, most are able to 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 2 standard drinks in a day and preferably not every day.
A standard drink is equal to:
- One small glass of wine (100ml)
- One middy of full strength beer (285ml)
- One nip of spirits (30ml)
Be aware of the quantity of alcohol you drink and don't let anyone persuade you to drink more. Alcohol and antiepileptic medications 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 drinks with cola contain caffeine. In 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.
Infections and illness
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.
Lack of sleep
This is a common trigger factor. Everyone differs in the amount of sleep they need, however avoid wild fluctuations in the time you go to bed and make sure you get enough sleep to feel rested.
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, alteration in hormonal levels and alteration in the blood levels of antiepileptic medications. 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.
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 hospitalization.
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 important to tell your doctor about all the medications you take. And this includes telling him or her about any over the counter herbal or vitamin supplements that you are taking or planning to take.
Other possible triggers
There are other possible triggers with some unique to certain people. For example some unusual stimuli known to trigger seizures include the colour yellow, the smell of glue and sounds such as the telephone ringing or a siren.
Photosensitive epilepsy is rare affecting only a small number of people with epilepsy. With photosensitive epilepsy seizures are triggered by sensory stimuli such as flickering sunlight, strobe
lights and flickering television. Simple preventative measures can be taken to as 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.
Severe changes in temperature
In some people seizures may be triggered when the weather becomes very warm or rooms are overheated.
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 recognize 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 might be options worth trying.
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This fact sheet was written by Epilepsy Australia and appears on www.epilepsyaustralia.net Epilepsy Queensland is an affiliate of Epilepsy Australia and has permission to print this information. This fact sheet has been reviewed and updated by Dr. Cecilie Lander, Brisbane July 2015. To be reviewed and updated in 2017.