Seizure trigger factors
Some people, although not all, find that certain
factors 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.
Alcohol
Most people with epilepsy can safely drink a
moderate amount of alcohol, however some people
find even small amounts of alcohol can trigger
seizures. Moderate drinking means having 2
standard drinks a day. A standard drink is equal
to one small glass of wine (100ml), one middy of
full strength beer (285ml) or 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.
Diet
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. Ask your doctor what you should do
if this occurs.
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.
Menstruation
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.
Missed medication
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.
Remembering to take medication regularly can be
a problem. Many people with epilepsy experience
difficulty with their short-term memory. Using a
dosette box can help. It may also be helpful to
carry a daily dose of your medication with you
in case you are not at home in time to take the
next dose.
The traditional advice on missing a dose has
often been to simply pass on it and not to try
to catch up. That is not always a good idea.
Leading Sydney neurologist Ernie Somerville
supports the current view that you should take
the missed dose as soon as you realise it was
missed, even if this isn’t until the next dose
is due. That is, you should catch up. The risk
of this is minor overdosage, the symptoms of
which are not serious and will last no more than
a couple of hours, while the risk of not doing
so is a seizure. Make sure you discuss this with
your doctor. Better yet, make sure you don’t
miss a dose. According to Dr Somerville some of
the things you can do to remind yourself to take
your medication is to make it part of your daily
routine – take it with meals or take it when you
get up and when you go to bed. To help you
remember, you can keep your tablets on top of
your pillow or in the kitchen. Some people use
digital watch alarms to remind them. It is more
important to take your medication at a time when
you are more likely to remember than at exactly
12 hourly [or 8 hourly] intervals.
Other drugs
Withdrawal from sedative and hypnotic drugs
including minor tranquillisers, 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.
Legally prescribed drugs that may lower seizure
threshold and some of the more commonly known
interactions with over-the-counter products are
discussed further on.
Other possible triggers
There are other possible triggers with some
unique to certain people. For example some
unusual stimuli which has been known to trigger
seizures include the colour yellow, the smell of
glue and sounds such as the telephone ringing or
a siren.
Photosensitivity
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 decrease
seizures triggered this way such as 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
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,
meditation, breathing exercises or aerobic
exercise might be options worth trying.
