Epilepsy Seizure Triggers

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

Epilepsy is a neurological condition that causes seizures. Neurological conditions affect the brain and nerves. Some people find their epilepsy seizures are triggered by certain things or situations. One person’s triggers may be totally different from someone else’s.1

A trigger is not the same thing as a cause. Epilepsy is caused by an underlying genetic condition or damage to the brain. However, the cause is unknown in about half of cases. A trigger is a situation that leads to seizures in someone with epilepsy.1,2

Common epilepsy seizure triggers

There are several common epilepsy seizure triggers, including:1,3

  • Not taking anti-seizure drugs as prescribed
  • Lack of sleep
  • Stress
  • Illegal drugs, binge drinking, or heavy drinking
  • Menstruation
  • Illness, especially infections
  • Flashing lights or patterns
  • Over-the-counter medicines and supplements

Missed anti-seizure drugs

Missed medicine is the most common reason why people have seizures when their epilepsy was controlled before. If someone has poorly controlled epilepsy, missing doses of anti-seizure medicine may cause more frequent or more intense seizures. Missed doses also make status epilepticus more likely.1

If you miss a dose, do not panic. Generally, you should take your medicine as soon as you remember it. But do not double up on doses if it is almost time for your next dose. Always call your doctor if you are unsure what to do.1

Lack of sleep

Sleep and epilepsy have a complicated relationship. Electrical activity and hormone levels change when we sleep. In some people with epilepsy, these changes may trigger seizures. However, not getting enough sleep may also trigger seizures for the same reason.4

Adding to the problem, some anti-seizure drugs cause insomnia. Sleep apnea is common in those with epilepsy, which reduces sleep quality.

Stress and epilepsy

Stress means something different to every person. Life events can cause stress for both happy or sad reasons. This makes it hard to predict if or when stressful events will trigger someone’s epilepsy.

Plus, doctors do not really understand why stress causes seizures in some people. In general, stress can cause hormonal changes in the body and disrupt sleep. Both of these changes can trigger seizures. One study found that people who take steps to manage their stress believed it reduced their seizures.5

Binge drinking, heavy drinking, or illegal drugs

Alcohol can be problematic for people with epilepsy. Adult beverages in small amounts (1 to 2 drinks a day) may not cause seizures. However, drinking large amounts over a short or long time may trigger seizures. The seizures tend to happen some time after drinking, as alcohol is processed in the body. Also, some anti-seizure drugs should not be mixed with alcohol.6

Illegal drugs are another danger area for people with epilepsy. All drugs can lower the seizure threshold by causing changes to the brain. Cocaine can cause seizures in seconds to hours after it is taken. Stimulants like ecstasy (MDMA) and opium-related drugs like heroin may cause people to forget to take their anti-seizure medicines. Not taking anti-seizure medicine as prescribed can trigger seizures.7


About half of girls and women with epilepsy report their seizures increase at some point in their menstrual cycle. Studies show this most often occurs around ovulation, or about a week before bleeding begins.8

Illness (infection)

Colds, the flu, sinus infections, bladder infections, and stomach bugs can all trigger seizures in people with epilepsy. This may be due to fever, dehydration, or poor sleep. Over-the-counter drugs and prescription medicines given to combat another illness may also trigger seizures.9

Flashing lights and patterns

About 3 out of 100 people with epilepsy have seizures triggered by flashing lights or certain patterns. This is called photosensitive epilepsy. It is more common in children and teens with certain epilepsy syndromes, particularly juvenile myoclonic epilepsy, or generalized epilepsy.10

Over-the-counter drugs

Many people assume that if a drug is available without a prescription that it is safe for anyone to take. However, some over-the-counter drugs can trigger seizures. This is especially true for some cold medicines.11

People with epilepsy report many other triggers, Some are rare, and others are hard to prove in scientific studies. Other triggers include exercise, certain foods, missed meals, and more.

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