Some people with epilepsy are more likely to have seizures when exposed to certain conditions. Triggers do not cause epilepsy, but they may make seizures more likely to happen.
People with epilepsy report many triggers. Some are common, such as missed medicine or lack of sleep. Others are rare or hard to prove in scientific studies, such as exercise and specific foods.
The first step to managing what triggers your seizures is to identify them so you can avoid them. This may take some time.
Keep a seizure diary
Keeping a seizure diary is an important first step to figuring out what your triggers are. As you record what happened just before and during a seizure, some patterns may appear.
Some people have triggers that are easy to identify. For others, it may take some time to figure out. Some triggers are out of your control. A trigger may affect seizures at certain times of the day or month but not others. Triggers may also change over the years.
Certain epilepsy syndromes are known to have certain triggers. For example, people with juvenile myoclonic epilepsy are often triggered by flashing lights.
There are many ways to keep a seizure journal. Some people prefer a paper calendar or notebook. Others like to use an online spreadsheet, calendar, or smartphone app.
Information to track in your seizure diary includes:1,2
- How much sleep you got and whether it was restful sleep
- The day’s stresses
- Whether you drank alcohol and how much
- Whether you forgot to take your anti-seizure drugs or took them off schedule
- If you skipped a meal
- If you have been sick, especially if you ran a fever
If you have a seizure, record what time it occured, anything you were doing just before the seizure, and even the day before.
Over time, you may notice patterns to what you were doing in the days or hours before a seizure. You may find that you have a high-risk time of day, week, or month. You may also be able to figure out when a situation results in a seizure and when it does not.3
Share information with your epilepsy team
Show the information in your seizure diary to your doctor and other members of your epilepsy team. They may notice patterns and triggers that you miss. They can also coach you on ways to fill information gaps. More complete or different information may be helpful in learning more about your triggers.3
Once your triggers are known, they can also suggest lifestyle changes to help you avoid your triggers as much as possible.
Common seizure triggers
While everyone’s triggers are different, there are several triggers that are more common, including:1,2
- Not taking anti-seizure drugs as prescribed or skipping doses
- Lack of sleep or being tired
- Stress
- Illegal drugs, binge drinking, or heavy drinking
- Menstruation
- Illness, especially infections that cause a fever
- Flashing lights or patterns
- Skipping meals
- Over-the-counter medicines and supplements
Trigger management
Some seizure triggers are easier to avoid or manage than others. No one can avoid all triggers, but by taking charge of what you can control, you can help keep yourself as healthy as possible.
Some common suggestions for trigger management include:4
- Drug management – Taking your anti-seizure drugs consistently is the most important thing you can do to take control of your seizures. Build reminders into your day if you forget to take your drugs. Enlist a loved one to help you remember. Talk to your doctor if you cannot afford your prescription. There may be lower-cost alternatives. Your doctor can sometimes explain things to your insurance company and help you get a better price.
- Noises – Wear earplugs or headphones, especially in loud places.
- Flashing lights – Wear polarized or tinted glasses. Focus on distant objects when riding in a car. Avoid flashing holiday decorations and places that use strobe lights. Get a computer monitor screen filter.
- Sleep – Stick to a regular sleep schedule and practice good sleep habits. If you snore, get checked for sleep apnea.
- Diet – Eat meals on a regular schedule that supports your medicine schedule. Avoid going a long time without eating.
- Stress – Exercise regularly. Practice relaxation techniques like meditation, prayer, yoga, or deep breathing. Stay in touch with friends and family. If you are depressed, anxious, or simply want someone to talk to, seek counseling.
- Illness and injury – If you are sick or injure yourself, let your epilepsy doctor know right away. They can help you manage the antibiotics and over-the-counter drugs you may need to prevent reactions with anti-seizure drugs. Get age-appropriate vaccinations, including an annual flu shot.
Doing what you can to manage your seizure triggers takes work. But the payoff may be a better quality of life due to fewer seizures.