Epilepsy Talk

Common epilepsy triggers… | March 27, 2023

Epilepsy affects each person differently. Below is a guide to some common seizure triggers. You may not feel or notice anything in particular. Or you may have triggers which are not mentioned here. Keeping a seizure diary is the most effective way of keeping track of what triggers your seizures.

Reflex Epilepsy

Some people notice that their seizures occur in response to very specific stimuli or situations, as if the seizure is an automatic “reflex.”  In this type of seizure, it occurs consistently in relation to a specific trigger. For example, one type of reflex epilepsy is photosensitive epilepsy where seizures are triggered specifically by flashing lights. Other types of reflex epilepsies can be seizures triggered by the act of reading or by noises. These reflex epilepsies are not common. However, knowing the type of epilepsy and trigger is important information for a correct diagnosis. You can then work on eliminating these triggers whenever possible or find ways to lessen their effect on you.

Stress

Stress can increase cortisol, known as “the stress hormone” because cortisol is secreted in higher levels during the body’s “fight or flight” response to stress.  And, as you may imagine, it’s responsible for several stress-related changes in the body which also may influence seizure activity.

Negative emotions related to stress, such as anger, worry or fright, may also cause seizures. This happens because the limbic system, the portion of the brain that regulates emotion, is one of the most common places for seizures to begin.  You’ll probably find that you have more seizures during or after periods of anxiety or stress.

Lack of Sleep

Inadequate or fragmented sleep can set off seizures in lots of people. In one study, the lowest risk for seizures was during REM sleep (when dreams occur). The highest risk was during light non-REM stages of sleep.

Flickering or Flashing Light

If you have photosensitive epilepsy, certain types of flickering or flashing light may incite a seizure.  The trigger could be exposure to television screens due to the flicker or rolling images, computer monitors, certain video games or TV broadcasts containing rapid flashes, even alternating patterns of different colors, in addition to intense strobe lights.

And surprisingly, seizures may be triggered by natural light, such as sunlight, especially when shimmering off water, even sun flickering through trees or through the slats of Venetian blinds.

Heat

Heat-induced seizures, are most commonly experienced by children. However, only one in 100 kids who experience this type of seizure is also diagnosed with epilepsy and many outgrow the condition before they reach the age of five.

Hormones

For many women, certain hormones seem to trigger seizures at particular times in their menstrual cycle. It can be during ovulation, menstruation, pregnancy or menopause.  This is known as “catamenial epilepsy.” If you’re going through menopause, you may find that the hormonal changes at this time make you more likely to have seizures, (although for some women, seizures will not be affected or become less frequent).

Food Allergies

Both food sensitivities and allergies can definitely trigger seizures.  Especially foods that are rich in glutamate and aspartame — two very excitatory amino acids.  Food allergies may also trigger seizures in children who also have migraine headaches, hyperactive behavior and abdominal pains.

Illness

High fevers in children can commonly incite a seizure.  Vomiting, diarrhea, and fever are all triggers. And vomiting may reduce the dosage level of previously ingested anti-seizure medication.  As for adults, they usually weather illness fine but it can reduce the seizure threshold, and make you more likely to have a seizure.

Missed Medication

One of the most common causes of a seizure is failure to take the right medication according to the appropriate intervals. Anti-epileptic medications need to be taken on a daily basis, often at a consistent time in order to have the right effect. Skipping a dose could lead to “breakthrough seizures”, which often happen without warning.

Prescription Drugs

Some prescription medications — especially penicillin, anti-depressants and anti-anxiety drugs — can prevent your medication from working. It could be caused by the way your system responds to a certain a drug, a combination of drugs, reaction or withdrawal. Make sure all your doctors know everything you take.

Over-the-Counter-Drugs

Certain over-the-counter medications are considered safe for those with epilepsy. For runny and stuffed noses, consider strong pseudoephedrine or phenylephrine. (Although there are reports of seizures caused by these drugs too!) For aches and pains, acetaminophen (such as Tylenol, Panadol, Excedrin Aspirin Free) is probably the safest medication.

Alcohol

There are two questions that have to be considered when the question of alcohol use and epilepsy comes up. One is the effect that alcohol could have on the medicines used to control seizures. Alcohol can be dangerous when mixed with sedative drugs and can cause coma, or even death. The other question is whether the alcohol itself will cause seizures.

Large amounts of alcohol are thought to raise the risk of seizures and may even cause them. When you drink alcohol, it may temporarily reduce seizures for a few hours, but then increases the chances of a seizure as the alcohol leaves your body.

Cigarette Smoking

Nicotine is both a stimulant and a depressant to the central nervous system. The nicotine in cigarettes acts on receptors for the excitatory neurotransmitter acetylcholine in the brain, which increases neuronal firing.

But if you want to STOP smoking, here’s a piece of scary information: some nicotine preparations used to help people stop smoking can have a side effect of convulsions. So, if you’re thinking of quitting, check out your smoking cessation program with your doc first.

Caffeine

Much like nicotine, caffeine stimulates the nervous system. Adrenaline is released and the liver begins to emit stored blood sugar. Insulin is then released, and blood sugar drops below normal—a common seizure trigger.  And caffeine can be a “stealth” drug, too.  It can be found as an ingredient in medications, including some antihistamines and decongestants.

Musicogenic Epilepsy

This is a form of reflexive epilepsy in which a seizure is triggered by music or specific frequencies. Sensitivity to music varies from person to person.  Some people are sensitive to a particular tone from a voice or instrument. Others are sensitive to a particular musical style or rhythm. Still others are sensitive to a range of noises.

Individual Triggers

A common trigger is too much heat, internal from extremely excessive exercise or external from an overheated house or apartment.  Other triggers include the smell of glue and the color yellow! Many people have their own specific triggers, while others don’t.  It’s a combination of possibilities: personal chemistry, biology and genetics.

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Resources:

https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2019/august/surprising-epilepsy-seizure-triggers#:~:text=Missed%20medication%2C%20lack%20of%20sleep,frequent%20than%20you%20might%20imagine.

https://www.epilepsyscotland.org.uk/12-most-common-seizure-triggers/

https://www.medicalnewstoday.com/articles/seizure-triggers

https://www.myepilepsyteam.com/resources/triggers-and-epilepsy

https://magazine.circledna.com/10-common-epilepsy-triggers-to-watch-out-for/

https://www.verywellhealth.com/epilepsy-triggers-6834004

http://stress.about.com/od/stresshealth/a/cortisol.htm

https://www.epilepsy.com/learn/triggers-seizures

https://www.epilepsysociety.org.uk/seizure-triggers#.Weox8WhSztU

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