How can people identify potential seizure triggers?

List of common triggers

Some people with epilepsy or who have recurrent seizures may notice that they occur in patterns or in certain situations. These factors, or seizure triggers, may make seizures more likely. However, some people who have epilepsy may not have any triggers. Some potential seizure triggers can include:

Missed medications

Regularly taking anti-epileptic drugs ensures a steady level of the medication in a person’s body. Missing a dose may increase a person’s risk of seizures and cause seizures to be more intense or occur more often.

Not taking them as prescribed may lead to status epilepticus, a prolonged seizure that health experts consider a medical emergency.

Sleep deprivation and tiredness

Some researchers say that seizures and sleep have a bidirectional relationship, where seizures may cause a lack of sleep, and lack of sleep may trigger seizures.

A 2020 study found that people with epilepsy had poor sleep quality and were sleepy during the day. It also showed that poor sleep quality could lead to seizures.

Stress

Stress is a commonly reported trigger for seizures. However, the exact relationship between the two is unknown. Everyone experiences stress differently, and stress presents in various forms. A person could experience stress due to major life events or a buildup of daily hassles.

Stress can take a physical toll on the body and may cause a lack of sleep, changes in eating habits, and alcohol or substance misuse — all of which can trigger seizures.

Alcohol

Consuming alcohol in small amounts is unlikely to cause seizures. However, drinking an excessive amount of alcohol over a short period may trigger a seizure, even for people who do not have epilepsy.

Alcohol-related seizures are more common when the effects of alcohol on the body are wearing off. They can occur 6–72 hours after drinking. Consuming alcohol can also disrupt sleep or affect medications, increasing the risk of a seizure.

Flashing lights

In individuals with photosensitive epilepsy, flashing lights or contrasting patterns can trigger a seizure. This type of epilepsy is rare, and only about 3% of people with epilepsy experience photosensitive seizures. Evidence also suggests that this type is more common among females and younger people.

Nutrition and deficiencies

If a person with diabetes experiences severe hypoglycemia, which may occur from skipping meals, their extremely low blood sugar levels could trigger a seizure.

Sometimes, vitamin and mineral deficiencies may also trigger seizures. Vitamin B6 deficiency may trigger seizures in babies but is less common in adults. Altered levels of minerals, such as calcium, sodium, potassium, and magnesium, can affect brain cell electrical activity and lead to seizures.

Illness and infection

Illness can also trigger seizures in some people. This may be due to the physical stress the illness puts on the body, lack of sleep, poor eating habits, certain medications, or dehydration.

Viral infection of the central nervous system commonly triggers seizures. Occasionally, common illnesses such as a sinus infection or a cold can trigger seizures.

Menstruation

Some people may experience catamenial epilepsy, which refers to seizures that become worse or more frequent during certain times of the menstrual cycle. This is very rare, and evidence suggests this occurs due to changes in levels of the hormones progesterone and estrogen.

Weather

A 2017 study from Germany suggests that low atmospheric pressure and high humidity conditions can trigger seizures. However, research into the effect of weather on seizure risk is not definitive.

A 2018 study from Lisbon, Portugal, notes that more seizures happen during winter. However, a 2020 survey by the Epilepsy Society found that very hot weather may cause breakthrough episodes in well-controlled seizures and may cause uncontrolled seizures to be more severe and intense. This indicates that extremes in temperature may cause changes in the body that trigger seizures.

Certain medications

Some over-the-counter medications may potentially trigger seizures. A 2016 study mentions that antidepressants, stimulants, tramadol, and isoniazid are medications commonly reported to trigger seizures in some people.

Causes vs. triggers

The cause of epilepsy is unknown in 2 out of 3 people. However, it can result from genetic disorders or conditions affecting the brain, such as stroke, traumatic brain injury, infections, or other neurological diseases.

While a trigger can result in a seizure, seizure triggers are not the same as seizure causes. For example, a stressful situation can trigger a seizure, but the underlying cause could be structural damage to the brain.

As seizures can be unpredictable, it can be difficult to determine why they occur. Some people may assume that triggers, such as tiredness, are the cause. However, it is more likely that the individual was already susceptible, and the trigger induced the seizure.

Reflex seizures

Seizures are often unpredictable and may occur spontaneously. While some people can identify triggers, others may have non-specific triggers, such as stress or tiredness.

However, others may experience reflex seizures, which occur consistently due to specific and identifiable stimuli or cognitive processes.

Potential stimuli for reflex seizures can be external, such as seeing flashing lights or touching hot water, or internal, such as feeling certain emotions or having certain thought processes. This is very rare.

How to identify triggers

It can be difficult and may take some time for an individual to identify their personal seizure triggers. A person can keep a seizure diary to note their activities or situations preceding a seizure. A pattern may emerge over time, revealing possible seizure triggers.

While attempting to identify possible triggers, a person should try to manage their condition and avoid or reduce exposure to potential triggers. Tips people can try include:

• taking medication as their doctor prescribes
• getting enough and regular sleep
• lowering stress

Frequently asked questions

Here are some questions people often ask about seizure triggers.

What causes a seizure all of a sudden?

Seizures can happen suddenly and unexpectedly for various reasons. They include fever, changes in sodium or glucose levels, sepsis, a traumatic brain injury, alcohol use, a brain tumor, stroke, low oxygen supply to the brain, changes in medication, use of recreational drugs, an infection, and sleep deprivation.

Are seizures the same as epilepsy?

When a person has two or more seizures at least 24 hours apart without an obvious cause, a doctor will diagnose epilepsy. A person with epilepsy is prone to seizures, possibly due to specific brain structures.

What foods can trigger a seizure?

Foods cannot usually trigger a seizure, but some people have eating epilepsy, a rare condition in which consuming food triggers a reflex seizure.

In a 2020 systematic review, foods that triggered seizures in some individuals were rice-based meals, spicy foods, meat, fish, oily foods, milk, hot foods, cold foods, apples, pears, bread, porridge, and strawberry syrup.

However, it is worth noting that out of 216 participants, fewer than 10 had seizures with most of these foods, while 67 had them after eating rice.

Summary

Seizure triggers refer to stimuli that may induce a seizure in certain people. Triggers can vary among individuals, but common triggers include illness, tiredness, alcohol, and missing medication.

Triggers are different from causes. Underlying conditions often cause seizures, while triggers induce seizures in people already predisposed to them.

It can be difficult for people to identify their own personal triggers, but keeping a diary of potential triggers and trying to avoid certain stimuli may help prevent a seizure from occurring.