In addition to genetic susceptibility and/or brain damage caused by various factors in the pathogenesis of epilepsy, there are other factors that can promote and induce seizures, which are called triggers of epilepsy. Some of these factors cannot be changed by people’s will, while others can be changed and prevented. Therefore, it is important for people with epilepsy and their families to understand these triggers to help patients reduce and avoid seizures by making lifestyle adjustments.
I. Non-modifiable factors
The triggers of epilepsy that cannot be easily changed include gender, age, genetic factors, menstruation, pregnancy, awakening and sleep, etc. These are factors that you cannot change or prevent.
Factors that can be changed
The factors that can be changed are those that can be minimized through the efforts of patients and their families to effectively control the seizures.
(i) Mental stress
Some studies have shown that patients with epilepsy have an increased number of seizures when they are stressed, anxious or depressed. Part of the reason for this phenomenon may be poor sleep in this state. Modern society is a fast-paced and stressful place to live. Patients with epilepsy not only have to endure the pain of the disease itself, but also have to suffer more stress than normal people, with a heavy psychological burden and, in severe cases, anxiety, depression and various other psychological problems. In fact, stress is part of everyone’s daily life, and it is necessary to try to resolve it and reduce the psychological burden. If you still can’t get a good psychological state through self-regulation, it is recommended to go to a psychologist for consultation and treatment.
(B) Light and other forms of stimulation
Some patients with epilepsy are diagnosed with reflex epilepsy, mainly because these patients are exposed to a specific sensory stimulus that can induce out seizures. The most common type is photosensitive epilepsy, which is epilepsy induced by repeated flashes of light stimuli. Commonly, seizures can be induced by watching television, playing video games, or riding in a car on the road looking at sunlight through a gap in the trees. Reading epilepsy is also a specific type of visually evoked epilepsy. Others are auditory reflex epilepsy (e.g. sudden sounds, certain music, etc.), tactile epilepsy (e.g. touching or stretching muscles, etc.), hot bath epilepsy, exercise-induced epilepsy, viscerally induced reflex epilepsy (e.g. mealtime, urination, etc.), and mental reflex epilepsy (e.g. induced by calculation, playing cards, mahjong, or chess). Once diagnosed with reflex epilepsy one should try to avoid seizure provoking factors.
(iii) Sleep deprivation
Lack of sleep can trigger seizures. Maintaining regular sleep is essential for people with epilepsy. You should try to avoid sleeping too late or staying up all night (such as working the night shift or traveling poorly). In choosing a job, try to avoid choosing a job that requires staying up late or working the night shift.
(iv) Fatigue
Excessive fatigue can induce all types of seizures. Patients with epilepsy should develop a regular, healthy lifestyle and avoid overexertion.
(v) Hormones
Some women with epilepsy have seizures related to their menstrual cycle, often with an increased number of seizures during the premenstrual and menstrual periods. This is mainly related to changes in estrogen and progesterone levels in the body. If a patient is predisposed to this, they should keep detailed records of seizures in relation to their menstrual period and consult with a specialist (see Epilepsy and Women).
(vi) Food
Some patients with epilepsy believe that consumption of certain foods can trigger seizures, but there is no evidence that a certain food must be abstained from in patients with epilepsy. It is important to emphasize that picky or unbalanced eating habits may be a trigger for seizures.
(vii) Discontinuation of medication
Abrupt discontinuation of antiepileptic drugs can precipitate seizures and even lead to persistent status epilepticus.
(viii) Sensory factors
Some patients are more sensitive to specific sensory factors, most notably such as vision, hearing, smell, taste, vestibular, and somatosensory. These sensory stimuli can stimulate excessive abnormal firing of brain neurons, causing various types of seizures (called reflex epilepsy).
(ix) Alcohol
Excessive alcohol consumption can induce seizures in people with epilepsy, even in people without epilepsy. Alcohol consumption is now a part of many people’s lives. Many people with epilepsy are anxious to know how much alcohol consumption affects epilepsy. Here is some clear, unbiased information for people with epilepsy and their families.
Earlier we talked about “seizure thresholds” and how everyone is born with a “seizure threshold”. Those with a low “seizure threshold” are more likely to experience seizures than others with a high “seizure threshold”. In addition, there are certain events that can lower the innate “seizure threshold. These factors include brain damage due to various causes and applications of various substances.
Alcohol has an effect on the brain, and excessive alcohol consumption predisposes to seizures. Also, alcohol interacts with antiepileptic drugs, and alcohol makes antiepileptic drugs less effective. The patient’s lack of sleep, not eating or missing antiepileptic drugs after drinking alcohol can trigger seizures.
1, can drinking alcohol cause epilepsy?
Alcohol can induce epileptic drinking seizures. 5-15% of excessive alcoholics have seizures, and 2/3 of them are associated with alcohol withdrawal. About 20% of newly diagnosed adult epilepsy patients are caused by excessive alcohol consumption. Excessive alcohol consumption increases the risk of developing epilepsy threefold. Severe excessive alcohol consumption is an independent, dose-related risk factor for epilepsy. Some people who drink alcohol continuously or have multiple post-drinking seizures are at high risk of developing epilepsy. Even if alcohol consumption is stopped completely, seizures may continue and require the application of antiepileptic drugs for seizure control. In addition, alcohol consumption increases the risk of head trauma, which on the other hand increases the risk of seizures. In patients with seizures, alcohol consumption leads to missed antiepileptic medications, decreased drug absorption and hepatic enzyme-inducing effects of alcohol, resulting in lower concentrations of antiepileptic drugs in the blood of patients with epilepsy and inducing seizures.
Post-alcohol withdrawal seizures are usually seen in long-term heavy drinkers who suddenly stop drinking alcohol. The most common seizures typically occur 18-24 hours after stopping drinking, with 90% occurring within 8-48 hours of stopping drinking. The most common seizure scenario is two to four consecutive seizures within a 6-hour period. About 60% of patients present with multiple seizure types, about 3% have persistent status epilepticus, and 30% develop delusional tremor.
In some patients with epilepsy, even small amounts of alcohol can induce seizures, and for these patients it is best to choose not to drink alcohol.
What is the relationship between alcohol consumption and the use of antiepileptic drugs?
The first thing you need to do is to take antiepileptic drugs to increase the body’s sensitivity to alcohol, so that the toxic effects of alcohol on the body increase. At the same time, alcohol can aggravate the adverse effects of some antiepileptic drugs, for example, taking carbamazepine can cause dizziness, drowsiness or headache, all these adverse effects may be aggravated by drinking alcohol. It is also important that people with epilepsy do not miss their antiepileptic medications before drinking alcohol, as missing antiepileptic medications is more likely to trigger a seizure than occasional alcohol consumption.
3. Conclusion
Alcohol can cause seizures, it can increase the side effects of antiepileptic drugs and aggravate the negative effects of alcohol on the organism. Excessive alcohol consumption may increase the risk of seizures while leading to other health problems.
(x) Substance abuse
Substance abuse is actually a social problem. When a drug is abused for addiction, it has lost its original use and has become a drug. These illegal drugs, can consist of many different ingredients. There is no quality assurance. In addition to the drugs themselves, which can induce seizures, taking these drugs often causes other problems such as not getting enough sleep, poor diet, etc. Therefore, in addition to the other harms caused by drug abuse, each person with apparent epilepsy has to take the risk of having a seizure for this reason. The following is a description of the relationship between common addictive drugs and apparent seizures.
1. Marijuana: The quality of marijuana varies greatly, as do its uses. Some reports show that marijuana can reduce seizures, while others report that marijuana can aggravate seizures.
2. Hallucinogens (intoxicants): Studies have shown that hallucinogens can increase the amount of certain compounds in the nervous system and that nerve cells are overstimulated. One result of this stimulation is the manifestation of seizures. In addition, hallucinogens are often applied in conjunction with a number of other illegal drugs. There is evidence that hallucinogens can induce seizures when applied together with these illegal drugs. Taking hallucinogens may lead to overactivity, such as dancing all night long. If a person with epilepsy drinks too much water after excessive activity, this may lead to water intoxication and consequently cause seizures to occur.
3. Heroin (morphine): Heroin itself can cause seizures, but most often it is due to the patient taking other illegal drugs at the same time, drinking alcohol at the same time, or taking too much heroin at one time. Heroin can be injected into the body intravenously, and various infections caused by the use of unclean needles during injection can also cause seizures. In addition, because heroin can be mixed with a number of other substances, these substances themselves may trigger seizures. Some medications used to treat heroin addiction can lower the patient’s seizure threshold and cause seizures. Patients with epilepsy who are addicted to heroin should discuss medication with their doctor.
4. Amphetamines: Seizures can be caused when an abnormal overdose of amphetamines is taken. Amphetamines can also induce seizures when used in conjunction with other offending drugs. Because amphetamines are a stimulant, people can use them to refresh themselves. If a person with epilepsy takes it, it can cause a seizure due to lack of sleep.
Cocaine: Cocaine can lower the seizure threshold or cause other medical problems that can lead to seizures. Cocaine can induce seizures in people without epilepsy and can also aggravate the condition in some people with epilepsy. Seizures may also be caused by indirect causes such as lack of sleep or missed antiepileptic drugs after taking cocaine.
6, steroid hormones: refers to anabolic steroids mainly applied in sports, the drug can induce seizures in patients with epilepsy.
(xi) Other factors
1, tobacco: there is no evidence that smoking cigarettes or cigars can induce seizures. However, one of the side effects of nicotine preparations often used to quit smoking is to cause convulsive seizures. For patients with epilepsy who want to quit smoking, it is important to talk to your doctor before purchasing any nicotine preparations.
2. Coffee: Pure coffee can lower the seizure threshold, but there have been no reports that coffee or tea consumption in daily life can induce seizures.
3, evening primrose oil: the main component of evening primrose oil is γ-linolenic acid, has a lowering of blood lipids, anti-thrombotic and other effects, and is commonly used as a health product at home and abroad. In foreign countries through the epilepsy hotline interviews show that the use of evening primrose oil can make epilepsy patients easier to seizures. 1984 published by Judy Graham. In 1984, the book “Evening Primrose” by Judy Graham described evening primrose oil as worsening temporal lobe epilepsy. In the 1980s, when schizophrenia was studied, the fact that evening primrose oil was associated with a risk of seizures was recognized. During routine treatment of schizophrenic patients taking evening primrose oil, it was found that patients who had not previously had epilepsy began to have seizures. It is not known, however, whether it was just the evening primrose oil that was responsible, as the patients were also taking other anti-schizophrenic medications.
Evening primrose oil can lower the seizure threshold and therefore increase the likelihood of seizures. The potential dangers of evening primrose oil need further study, and caution is advised for people with epilepsy and those with seizure susceptibility.
4. Mobile phones: With the development of technology, the use of cell phones covers the whole country, from urban to rural areas. The use of cell phones is increasing among both children and adults. Some studies believe that the use of cell phones can cause damage to children’s brains, because children’s brains are more susceptible to damage, but it is not conclusive. Experimental animal studies have found that cell phone emission signals can induce seizures. However, some experts believe that animal epilepsy and human epilepsy are not exactly the same, and that human skulls are larger and thicker than those of the cats used in the tests.
Researchers have given the following advice on whether people with epilepsy should use cell phones.
(1) Children with epilepsy who are younger than 14 years old should try not to use cell phones.
(2) Both children and adults should moderate their cell phone use and keep conversations as short as possible until clear research findings are available.
(3) For people with epilepsy who need to use their cell phones frequently, monitor their seizure frequency.
(4) Patients with vagal pacemakers should use their cell phones away from the instrument, i.e., do not put the cell phone in the outside pocket of the instrument implant site, and do not receive or make phone calls on the implant side.