Seizure trigger
Encyclopedia
A seizure trigger is a factor that can cause a seizure
in a person who either has epilepsy
or does not. There are many known causes of seizures, and in some patients, it is possible to determine what triggers seizures in general or has led to the onset of a particular seizure. But the factors that lead to a seizure are often so complex that it is not usually possible in all patients to determine what causes a particular seizure, what causes it to happen at a particular time, or how often seizures occur.
s triggering a seizure. Consuming alcohol may temporarily reduce the likelihood of a seizure immediately following consumption. But after the blood alcohol content
has dropped, chances may increase. This may occur, even in non-epileptics.
Heavy drinking in particular has been shown to possibly have some effect on seizures in epileptics. But studies have not found light drinking to increase the likelihood of having a seizure at all. EEG
s taken of patients immediately following light alcohol consumption have not revealed any increase in seizure activity.
Consuming alcohol with food is less likely to trigger a seizure than consuming it without.
Consuming alcohol while using many anticonvulsants may reduce the likelihood of the medication working properly. In some cases, it may actually trigger a seizure. Depending on the medication, the effects vary.
is practiced by some in order to control seizures.
Those with various medical conditions may suffer seizures as one of their symptoms. These include:
Some drugs may reduce the risk of a seizure occurring.
Withdrawals from drugs that act on the GABA receptors may lead to grand-mal seizures in people who have been heavily abusing drugs from the barbiturate or benzodiazepine families.
In children under the age of 5, fever
of 102°F (39°C) or higher can lead to a seizure (usually tonic-clonic) known as a febrile seizure
.
About 2-5% of all children will experience such a seizure during their childhood. Most of these children will also have some pre-existing neurological problem.
In most cases, a febrile seizure will not lead to epilepsy. But 30-40% of children who experience a febrile seizure will have more seizures in the future.
In adults and older children with epilepsy, illnesses with fever can be responsible for a seizure due to the stress that they cause. Additionally, in some patients, gastroenteritis
, which causes vomiting
and diarrhea
, can lead to diminished absorption of anticonvulsants, thereby reducing protection against seizures.
In some epileptics, flickering or flashing lights, such as strobe light
s, can be responsible for the onset of a tonic clonic
, absence
, or myoclonic seizure. This condition is known as photosensitive epilepsy
, and in some cases, the seizures can be triggered by activities that are harmless to others, such as watching television or playing video games, or by driving or riding during daylight along a road with spaced trees, thereby simulating the "flashing light" effect. Some people can suffer a seizure as a result of blinking one's own eyes. Contrary to popular belief, this form of epilepsy is relatively uncommon, accounting for just 3% of all cases. In all other epileptics, such lights are no more capable of triggering a seizure than in a non-epileptic person.
A routine part of the EEG
test involves exposing the patient to flickering lights in order to attempt to induce a seizure, to determine if such lights may be triggering a seizure in the patient, and to be able to read the wavelengths when such a seizure occurs.
A severe head injury, such as one suffered in a motor vehicle accident, fall
, assault
, or sports injury, can result in one or more seizures that can occur immediately after the fact or up to a significant amount of time later. This could be hours, days, or even years following the injury.
A brain injury can cause seizure(s) because of the unusual amount of energy that is discharged across of the brain when the injury occurs and thereafter. When there is damage to the temporal lobe
of the brain, there is a disruption of the supply of oxygen
.
The risk of seizure(s) from a closed head injury
is about 15%. In some cases, a patient who has suffered a head injury is given anticonvulsants, even if no seizures have occurred, as a precaution to prevent them in the future.
of certain drugs, though with most, the effect is quite rare, and for most patients, they are safe. These include:
Sudden withdrawal from anticonvulsants may lead to seizures. It is for this reason that if a patient's medication is changed, the patient will be weaned from the medication being discontinued following the start of a new medication.
Use of certain street drugs may also lead to seizures. These include amphetamines, cocaine
, methylphenidate
, and phenylpropanolamine
(not all of the drugs pictured).
If treated with the wrong kind medication antiepileptic drugs (AED), seizures may increase, as most AEDs are developed to treat a particular type of seizure.
, even if the patient has often missed doses in the past, and has not suffered a seizure as a result of the missed dose. Missed doses are one of the most common reasons for a breakthrough seizure
. Even a single missed dose is capable of triggering a seizure in some patients. This is true, even when the patient has not suffered a seizure after previously missing much more of his/her medication. Doubling the next dose does not necessarily help.
Missed doses can occur as a result of the patient's forgetfulness, unplanned lack of access to the medication, difficulty in affording the medication, or self-rationing of the medication when one's supply is low, among other causes.
is the second most common trigger of seizures. In some cases, it has been responsible for the only seizure a person ever suffers. But the reason why sleep deprivation can trigger a seizure is unknown. One possible thought is that the amount of sleep one gets affects the amount of electrical activity in one's brain.
Patients who are scheduled for an EEG test are asked to deprive themselves of some sleep the night before in order to be able to determine if sleep deprivation may be responsible for seizures.
In some cases, patients with epilepsy are advised to sleep 6-7 consecutive hours as opposed to broken-up sleep (e.g. 6 hours at night and a 2-hour nap) and to avoid caffeine
and sleeping pills in order to prevent seizures.
, anger
, anxiety
, or many other problems.
Stress may trigger a seizure because it affects the hormone cortisol
. Stress can also affect the part of the brain that regulates emotion.. Although stress can alter levels of these hormones, it remains unclear whether or not stress can directly result in an increase in seizure frequency.
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
in a person who either has epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
or does not. There are many known causes of seizures, and in some patients, it is possible to determine what triggers seizures in general or has led to the onset of a particular seizure. But the factors that lead to a seizure are often so complex that it is not usually possible in all patients to determine what causes a particular seizure, what causes it to happen at a particular time, or how often seizures occur.
Alcohol consumption
There are varying opinions on the likelihood of alcoholic beverageAlcoholic beverage
An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...
s triggering a seizure. Consuming alcohol may temporarily reduce the likelihood of a seizure immediately following consumption. But after the blood alcohol content
Blood alcohol content
Blood alcohol content , also called blood alcohol concentration, blood ethanol concentration, or blood alcohol level is most commonly used as a metric of alcohol intoxication for legal or medical purposes....
has dropped, chances may increase. This may occur, even in non-epileptics.
Heavy drinking in particular has been shown to possibly have some effect on seizures in epileptics. But studies have not found light drinking to increase the likelihood of having a seizure at all. EEG
EEG
EEG commonly refers to electroencephalography, a measurement of the electrical activity of the brain.EEG may also refer to:* Emperor Entertainment Group, a Hong Kong-based entertainment company...
s taken of patients immediately following light alcohol consumption have not revealed any increase in seizure activity.
Consuming alcohol with food is less likely to trigger a seizure than consuming it without.
Consuming alcohol while using many anticonvulsants may reduce the likelihood of the medication working properly. In some cases, it may actually trigger a seizure. Depending on the medication, the effects vary.
Alcohol withdrawal
Alcohol withdrawal is also responsible for seizures. This risk increases with each additional drink from which one has withdrawn.Caffeine
Caffeine use can increase the occurrence of seizures, particularly if it interrupts normal sleep patterns.Diet
Diet can play a role in a seizure occurring, and therefore, diet contol in some cases can be used to prevent seizures. It is not known exactly what nutrients or lack thereof may contribute to or prevent a seizure. However, the ketogenic dietKetogenic diet
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control epilepsy in children. The diet mimics aspects of starvation by forcing the body to burn fats rather than carbohydrates...
is practiced by some in order to control seizures.
Diseases
- Arteriovenous malformationArteriovenous malformationArteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. An arteriovenous malformation is a vascular anomaly. It is a...
- Brain abscessBrain abscessBrain abscess is an abscess caused by inflammation and collection of infected material, coming from local or remote infectious sources, within the brain tissue...
- Brain tumorBrain tumorA brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.Brain tumors include all tumors inside the cranium or in the central spinal canal...
- Cavernoma
- EclampsiaEclampsiaEclampsia , an acute and life-threatening complication of pregnancy, is characterized by the appearance of tonic-clonic seizures, usually in a patient who had developed pre-eclampsia...
- EncephalitisEncephalitisEncephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...
- MeningitisMeningitisMeningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs...
- Multiple sclerosisMultiple sclerosisMultiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
- Systemic lupus erythematosusSystemic lupus erythematosusSystemic lupus erythematosus , often abbreviated to SLE or lupus, is a systemic autoimmune disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage...
Drugs
Some drugs may lower the seizure threshold when used doses intended for recreation. Drugs such as tramadol and methamphetamine have been noted to induce seizures in some, especially when used for long periods of time or in combination with other stimulants.Some drugs may reduce the risk of a seizure occurring.
Withdrawals from drugs that act on the GABA receptors may lead to grand-mal seizures in people who have been heavily abusing drugs from the barbiturate or benzodiazepine families.
Fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
of 102°F (39°C) or higher can lead to a seizure (usually tonic-clonic) known as a febrile seizure
Febrile seizure
A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature...
.
About 2-5% of all children will experience such a seizure during their childhood. Most of these children will also have some pre-existing neurological problem.
In most cases, a febrile seizure will not lead to epilepsy. But 30-40% of children who experience a febrile seizure will have more seizures in the future.
In adults and older children with epilepsy, illnesses with fever can be responsible for a seizure due to the stress that they cause. Additionally, in some patients, gastroenteritis
Gastroenteritis
Gastroenteritis is marked by severe inflammation of the gastrointestinal tract involving both the stomach and small intestine resulting in acute diarrhea and vomiting. It can be transferred by contact with contaminated food and water...
, which causes vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...
and diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
, can lead to diminished absorption of anticonvulsants, thereby reducing protection against seizures.
Flickering or flashing lights
Strobe light
A strobe light or stroboscopic lamp, commonly called a strobe, is a device used to produce regular flashes of light. It is one of a number of devices that can be used as a stroboscope...
s, can be responsible for the onset of a tonic clonic
Tonic-clonic seizure
Tonic–clonic seizures are a type of generalized seizure that affects the entire brain...
, absence
Absence seizure
Absence seizures are one of several kinds of seizures. These seizures are sometimes referred to as petit mal seizures ....
, or myoclonic seizure. This condition is known as photosensitive epilepsy
Photosensitive epilepsy
Photosensitive epilepsy is a form of epilepsy in which seizures are triggered by visual stimuli that form patterns in time or space, such as flashing lights, bold, regular patterns, or regular moving patterns.-Symptoms:...
, and in some cases, the seizures can be triggered by activities that are harmless to others, such as watching television or playing video games, or by driving or riding during daylight along a road with spaced trees, thereby simulating the "flashing light" effect. Some people can suffer a seizure as a result of blinking one's own eyes. Contrary to popular belief, this form of epilepsy is relatively uncommon, accounting for just 3% of all cases. In all other epileptics, such lights are no more capable of triggering a seizure than in a non-epileptic person.
A routine part of the EEG
EEG
EEG commonly refers to electroencephalography, a measurement of the electrical activity of the brain.EEG may also refer to:* Emperor Entertainment Group, a Hong Kong-based entertainment company...
test involves exposing the patient to flickering lights in order to attempt to induce a seizure, to determine if such lights may be triggering a seizure in the patient, and to be able to read the wavelengths when such a seizure occurs.
Head Injury
Falling (accident)
Falling is a major cause of personal injury, especially for the elderly. Builders, electricians, miners, and painters represent worker categories representing high rates of fall injuries. The WHO estimate that 392,000 people die in falls every year...
, assault
Assault
In law, assault is a crime causing a victim to fear violence. The term is often confused with battery, which involves physical contact. The specific meaning of assault varies between countries, but can refer to an act that causes another to apprehend immediate and personal violence, or in the more...
, or sports injury, can result in one or more seizures that can occur immediately after the fact or up to a significant amount of time later. This could be hours, days, or even years following the injury.
A brain injury can cause seizure(s) because of the unusual amount of energy that is discharged across of the brain when the injury occurs and thereafter. When there is damage to the temporal lobe
Temporal lobe
The temporal lobe is a region of the cerebral cortex that is located beneath the Sylvian fissure on both cerebral hemispheres of the mammalian brain....
of the brain, there is a disruption of the supply of oxygen
Oxygen
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...
.
The risk of seizure(s) from a closed head injury
Closed head injury
Closed head injuries are a type of Traumatic Brain Injury in which the skull and dura mater remain intact. Closed head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people...
is about 15%. In some cases, a patient who has suffered a head injury is given anticonvulsants, even if no seizures have occurred, as a precaution to prevent them in the future.
Other medications
Seizures may be a side effectSide effect
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequences of the use of a drug.Occasionally, drugs are...
of certain drugs, though with most, the effect is quite rare, and for most patients, they are safe. These include:
- AminophyllineAminophyllineAminophylline is a bronchodilator. It is a compound of the bronchodilator theophylline with ethylenediamine in 2:1 ratio. The ethylenediamine improves solubility, and the aminophylline is usually found as a dihydrate-Properties:...
- Bupivicaine
- BupropionBupropionBupropion is an atypical antidepressant and smoking cessation aid. The drug is a non-tricyclic antidepressant and differs from most commonly prescribed antidepressants such as SSRIs, as its primary pharmacological action is thought to be norepinephrine-dopamine reuptake inhibition...
- Butyrophenones
- ChlorambucilChlorambucilChlorambucil is a chemotherapy drug that has been mainly used in the treatment of chronic lymphocytic leukemia...
- ClozapineClozapineClozapine is an antipsychotic medication used in the treatment of schizophrenia, and is also used off-label in the treatment of bipolar disorder. Wyatt. R and Chew...
- Enfluraneketamine
- EstrogenEstrogenEstrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
- Fentanyl
- InsulinInsulinInsulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....
- LidocaineLidocaineLidocaine , Xylocaine, or lignocaine is a common local anesthetic and antiarrhythmic drug. Lidocaine is used topically to relieve itching, burning and pain from skin inflammations, injected as a dental anesthetic or as a local anesthetic for minor surgery.- History :Lidocaine, the first amino...
- Meperidine
- PentazocinePentazocinePentazocine is a synthetically prepared prototypical mixed agonist-antagonist narcotic drug of the benzomorphan class of opioids used to treat moderate to moderately severe pain...
- Phenothiazines
- PrednisonePrednisonePrednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...
- ProcaineProcaineProcaine is a local anesthetic drug of the amino ester group. It is used primarily to reduce the pain of intramuscular injection of penicillin, and it was also used in dentistry. Owing to the ubiquity of the trade name Novocain, in some regions procaine is referred to generically as novocaine...
- Propoxyphene
- TheophyllineTheophyllineTheophylline, also known as dimethylxanthine, is a methylxanthine drug used in therapy for respiratory diseases such as COPD and asthma under a variety of brand names. Because of its numerous side-effects, the drug is now rarely administered for clinical use. As a member of the xanthine family, it...
- TramadolTramadolTramadol hydrochloride is a centrally acting synthetic opioid analgesic used in treating moderate pain. The drug has a wide range of applications, including treatment for restless legs syndrome and fibromyalgia...
- Tricyclic antidepressantTricyclic antidepressantTricyclic antidepressants are heterocyclic chemical compounds used primarily as antidepressants. The TCAs were first discovered in the early 1950s and were subsequently introduced later in the decade; they are named after their chemical structure, which contains three rings of atoms...
- The following antibiotics: IsoniazidIsoniazidIsoniazid , also known as isonicotinylhydrazine , is an organic compound that is the first-line antituberculosis medication in prevention and treatment. It was first discovered in 1912, and later in 1951 it was found to be effective against tuberculosis by inhibiting its mycolic acid...
, LindaneLindaneLindane, also known as gamma-hexachlorocyclohexane, , gammaxene, Gammallin and erroneously known as benzene hexachloride , is an organochlorine chemical variant of hexachlorocyclohexane that has been used both as an agricultural insecticide and as a pharmaceutical treatment for lice and...
, MetronidazoleMetronidazoleMetronidazole is a nitroimidazole antibiotic medication used particularly for anaerobic bacteria and protozoa. Metronidazole is an antibiotic, amebicide, and antiprotozoal....
, Nalidixic acidNalidixic acidNalidixic acid is the first of the synthetic quinolone antibiotics...
, and PenicillinPenicillinPenicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
, though Vitamin B6Vitamin B6Vitamin B6 is a water-soluble vitamin and is part of the vitamin B complex group. Several forms of the vitamin are known, but pyridoxal phosphate is the active form and is a cofactor in many reactions of amino acid metabolism, including transamination, deamination, and decarboxylation...
taken along with them may prevent seizures
Sudden withdrawal from anticonvulsants may lead to seizures. It is for this reason that if a patient's medication is changed, the patient will be weaned from the medication being discontinued following the start of a new medication.
Use of certain street drugs may also lead to seizures. These include amphetamines, cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
, methylphenidate
Methylphenidate
Methylphenidate is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, neural insult and obesity...
, and phenylpropanolamine
Phenylpropanolamine
Phenylpropanolamine , also known as the stereoisomers norephedrine and norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes which is used as a stimulant, decongestant, and anorectic agent. It is commonly used in prescription and over-the-counter cough...
(not all of the drugs pictured).
If treated with the wrong kind medication antiepileptic drugs (AED), seizures may increase, as most AEDs are developed to treat a particular type of seizure.
Missed dose
A missed dose or incorrectly timed dose of an anticonvulsant may be responsible for a breakthrough seizureBreakthrough seizure
A breakthrough seizure is an epileptic seizure that occurs, despite the use of anticonvulsants that have otherwise successfully prevented seizures in the patient...
, even if the patient has often missed doses in the past, and has not suffered a seizure as a result of the missed dose. Missed doses are one of the most common reasons for a breakthrough seizure
Breakthrough seizure
A breakthrough seizure is an epileptic seizure that occurs, despite the use of anticonvulsants that have otherwise successfully prevented seizures in the patient...
. Even a single missed dose is capable of triggering a seizure in some patients. This is true, even when the patient has not suffered a seizure after previously missing much more of his/her medication. Doubling the next dose does not necessarily help.
Missed doses can occur as a result of the patient's forgetfulness, unplanned lack of access to the medication, difficulty in affording the medication, or self-rationing of the medication when one's supply is low, among other causes.
Sleep deprivation
Sleep deprivationSleep deprivation
Sleep deprivation is the condition of not having enough sleep; it can be either chronic or acute. A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. It adversely affects the brain and cognitive function. Few studies have compared the...
is the second most common trigger of seizures. In some cases, it has been responsible for the only seizure a person ever suffers. But the reason why sleep deprivation can trigger a seizure is unknown. One possible thought is that the amount of sleep one gets affects the amount of electrical activity in one's brain.
Patients who are scheduled for an EEG test are asked to deprive themselves of some sleep the night before in order to be able to determine if sleep deprivation may be responsible for seizures.
In some cases, patients with epilepsy are advised to sleep 6-7 consecutive hours as opposed to broken-up sleep (e.g. 6 hours at night and a 2-hour nap) and to avoid caffeine
Caffeine
Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
and sleeping pills in order to prevent seizures.
Stress
In one study, emotional stress was reported by 30-60% prior to their seizures, thereby being the leading cause. This may include stress over hard work one is trying to accomplish, one's obligations in life, worries, emotional problems, frustrationFrustration
This article concerns the field of psychology. The term frustration does, however, also concern physics. In this context, the term is treated in a different article, geometric frustration....
, anger
Anger
Anger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....
, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, or many other problems.
Stress may trigger a seizure because it affects the hormone cortisol
Cortisol
Cortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
. Stress can also affect the part of the brain that regulates emotion.. Although stress can alter levels of these hormones, it remains unclear whether or not stress can directly result in an increase in seizure frequency.