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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.[1] Contents 1 Triggers 1.1 Alcohol consumption 1.1.1 Alcohol withdrawal 1.2 Diet 1.3 Diseases 1.4 Drugs 1.5 Fever 1.6 Flickering or flashing lights 1.7 Head Injury 1.8 Missed dose 1.9 Sleep deprivation 1.10 Stress 2 See also 3 References // Triggers Alcohol consumption The effects of alcoholic beverages on epileptics is not completely known There are varying opinions on the likelihood of alcoholic beverages 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.[2] 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. EEGs taken of patients immediately following light alcohol consumption have not revealed any increase in seizure activity.[3] Consuming alcohol with food is less likely to trigger a seizure than consuming it without.[4] 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.[5] Alcohol withdrawal Alcohol withdrawal is also responsible for seizures. This risk increases with each additional drink from which one has withdrawn.[6] Diet Diet can play a role in a seizure occurring, and therefore, diet contol in some cases can be used to prevent seizures[7]. It is not known exactly what nutrients or lack thereof may contribute to or prevent a seizure. However, the ketogenic diet is practiced by some in order to control seizures. Diseases Brain tumors are among many medical conditions in which seizures can be a symptom Those with various medical conditions may suffer seizures as one of their symptoms. These include: Arteriovenous malformation Brain abscess Brain tumor Cavernoma Eclampsia Encephalitis Meningitis Multiple sclerosis Systemic lupus erythematosus Drugs Various prescription and street drugs may cause seizures as a side effect Seizures may be a side effect of certain drugs, though with most, the effect is quite rare, and for most patients, they are safe. These include[8]: Aminophylline Bupivicaine Bupropion Butyrophenones Chlorambucil Clozapine Enfluraneketamine Estrogen Fentanyl Insulin Lidocaine Meperidine Pentazocine Phenothiazines Prednisone Procaine Propoxyphene Theophylline Tramadol Tricyclic antidepressant The following antibiotics: Isoniazid, Lindane, Metronidazole, Nalidixic acid, and Penicillin, though Vitamin B6 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, methylphenidate, and phenylpropanolamine[9]. Fever Main article: Febrile seizure A seizure can occur in small children with fever. This does not usually lead to permanent epilepsy. 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[10]. 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[11]. 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[12]. [13] Flickering or flashing lights Main article: photosensitive epilepsy Flashing light, such as that from a disco ball, can cause seizures in some people In some epileptics, flickering or flashing lights, such as strobe lights, can be responsible for the onset of a tonic clonic, absence, or myoclonic seizure[14]. 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[15]. Contrary to popular belief, this form of epilepsy is relatively uncommon, accounting for just 3% of all cases[16]. 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[17]. Head Injury A head injury, such as one suffered in a car accident, can result in seizures 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[18][19]. 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[20]. The risk of seizure(s) from a closed head injury is about 15%[21]. 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[22]. Missed dose A seizure can occur when a scheduled dose of an anticonvulsant is missed A missed dose or incorrectly timed dose of an anticonvulsant may be responsible for a breakthrough 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[23]. 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[24]. 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 Insufficient sleep is one of the most common causes of seizures Sleep deprivation is the second most common trigger of seizures.[25] In some cases, it has been responsible for the only seizure a person ever suffers.[26] 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.[27] 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.[28] In some cases, patients with epilepsy are advised to sleep 8 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.[29] Stress Stress has been shown to trigger seizures in epileptics.[30] This may include stress over hard work one is trying to accomplish, one's obligations in life, worries, emotional problems, frustration, anger, anxiety, or many other problems.[31] Stress can trigger a seizure because it affects the hormone cortisol. It can also affect the part of the brain that regulates emotion.[32][33] In one study, emotional stress was reported by 30-60% prior to their seizures, thereby being the leading cause.[34] See also Breakthrough seizure References ^ http://www.epilepsyfoundation.org/about/types/triggers/livingtrigger.cfm ^ http://books.google.com/books?id=TwlXrOBkAS8C&pg=PA78&lpg=PA78&dq=excessive+drinking+epilepsy&source=bl&ots=yTWUaL7bDL&sig=N2ZAcCqu1dLXoPOMRvc2MUka4w4&hl=en&ei=2NHCSpKTHMjPlAfL853IBQ&sa=X&oi=book_result&ct=result&resnum=8 ^ http://books.google.com/books?id=8cqg47-_gr8C&pg=PA92&dq=excessive+drinking+epilepsy&as_brr=3&ie=ISO-8859-1&output=html ^ http://www.epilepsyfoundation.org/living/wellness/alcohol/ ^ http://books.google.com/books?id=8cqg47-_gr8C&pg=PA93&lpg=PA92&dq=excessive+drinking+epilepsy&as_brr=3&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA63&lpg=PA61&dq=sleep+deprivation+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=imlgt9ziOqYC&pg=PA4&dq=malnutrition+seizure&lr=&as_brr=3&ie=ISO-8859-1&output=html ^ http://professionals.epilepsy.com/table/table_seniors_drugs.html ^ http://professionals.epilepsy.com/table/table_seniors_drugs.html ^ http://www.emedicinehealth.com/seizures_and_fever/page2_em.htm ^ http://www.emedicinehealth.com/seizures_and_fever/article_em.htm ^ w/index.php?title=Seizure_trigger&action=edit ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA67&dq=fever+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=gLOv8XZ5u48C&pg=PA129&lpg=PA128&dq=flickering+lights+seizure&as_brr=3&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=saFkKlDazIAC&pg=PA16&lpg=PA13&dq=flickering+lights+seizure&as_brr=3&ie=ISO-8859-1&output=html ^ http://findarticles.com/p/articles/mi_m0816/is_3_22/ai_n16033477/ ^ http://books.google.com/books?id=saFkKlDazIAC&pg=PA16&lpg=PA13&dq=flickering+lights+seizure&as_brr=3&ie=ISO-8859-1&output=html ^ http://www.braininjury.com/seizuresandheadinjury.html ^ http://www.merck.com/mmhe/sec06/ch087/ch087a.html ^ http://books.google.com/books?id=kicB_2cfFoUC&pg=PA124&lpg=PA125&dq=head+injury+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=wHS_97NyMsYC&pg=PA107&dq=head+injury+seizure&lr=&as_brr=3&ie=ISO-8859-1&output=html ^ http://www.epilepsyfoundation.org/answerplace/Medical/seizures/causes/headinjury.cfm ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA120&dq=%22missed+dose%22seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=y13wgJyQwkEC&pg=PA230&dq=%22missed+dose%22seizure&lr=&as_brr=3&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=TwlXrOBkAS8C&pg=PA77&lpg=PA77&dq=sleep+deprivation+seizure&source=bl&ots=yTWUaL8ewI&sig=W9OJxQJoIt3Oo4XCWYHEVOlWbFg&hl=en&ei=o9bCSobBJ8zQlAfXranoBA&sa=X&oi=book_result&ct=result&resnum=10 ^ http://www.epilepsy.com/epilepsy/provoke_sleepdep ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA61&dq=sleep+deprivation+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=iQQ1jMtU6HwC&pg=PA136&dq=sleep+deprivation+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA62&lpg=PA61&dq=sleep+deprivation+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=V0KcCgSWG5UC&pg=PA139&dq=stress+seizure&lr=&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=Q4QQAjtLP80C&pg=PA39&dq=stress+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=4SOA3rg5DK0C&pg=PA66&dq=stress+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=6lvXGInU2REC&pg=PA69&dq=stress+seizure&ie=ISO-8859-1&output=html ^ http://books.google.com/books?id=TwlXrOBkAS8C&pg=PA77&dq=stress+seizure&ie=ISO-8859-1&output=html v • d • e Seizures and epilepsy (G40-G41, 345) Basics Seizure types · Seizure trigger · Breakthrough seizure · Postictal state · Epileptogenesis · Aura (warning sign) Treatments Antiepileptics · Template:Anticonvulsants (for list) · Electroencephalography (diagnosis method) · Epileptologist Related disorders Todd's paresis · Landau-Kleffner syndrome · Epilepsy in animals Epilepsy organizations Epilepsy Foundation (USA) · Epilepsy Toronto · Epilepsy Research UK · Epilepsy Action Australia · Citizens United for Research in Epilepsy · Comprehensive Epilepsy Center · David Lewis Centre · Epilepsy Action · National Society for Epilepsy · International Dravet Epilepsy Action League Issues for epileptics Epilepsy and driving · Epilepsy and employment · Epilepsy in children Seizure types Epilepsy types Partial/focal Seizures: Simple partial · Complex partial · Jacksonian seizure Epilepsy: Temporal lobe epilepsy · Frontal lobe epilepsy · Rolandic epilepsy · Nocturnal epilepsy Generalised Tonic-clonic · Absence seizure · Atonic seizure · Automatism · Benign familial neonatal · Lennox-Gastaut · West Status epilepticus Epilepsia partialis continua · Complex partial status epilepticus Myoclonic epilepsy Progressive myoclonic epilepsy (Dentatorubral-pallidoluysian atrophy, Unverricht-Lundborg disease, MERRF syndrome, Lafora disease) · Juvenile myoclonic epilepsy Non-epileptic seizures Febrile seizure · Psychogenic non-epileptic seizures M: CNS anat(s,m,p,4,e,b,d,c,a,f,l,g)/phys/devp/cell noco(m,d,e,h,v,s)/cong/tumr,sysi/epon,injr proc,drug(N1A/2AB/C/3/4/7A/B/C/D)