What triggers seizures in Epilepsy?

Which circumstances can provoke Seizures?

This article is for patients with Epilepsy.

For factors which are severe enough to provoke seizures even in non-epileptic patients, read the following article below. Please note that this other article is essential to read even if you have Epilepsy – it is necessary for you to to avoid these provoking agents as well [Provoked seizures: Click here].

Here is the list of circumstances (taken from the article above) which can precipitate seizures if you have Epilepsy.

Factors which can precipitate Seizures if you have Epilepsy

High fever (Children)
Lack of sleep
Missing your Anti-Epileptic dose

Let us talk about these factors in detail.

If my child has a Seizure when he has a high fever, does it mean that he/she has Epilepsy?

In the vast majority of cases: No, the child does not have Epilepsy.

Children can have seizures when they have a fever.

Seizures which happen during a high fever are called “Febrile Seizures”. They usually occur in children.

  • In the vast majority of cases (>90%), Febrile Seizures do not indicate the onset of (or lead to the development of) Epilepsy.
  • Rarely, however, some Epilepsy syndromes which happen in Children may present initially with Febrile Seizures.
  • Some researchers multiple febrile seizures in childhood may slightly scar some brain parts, e.g. the “mesial temporal lobes”. This scarring may cause Epilepsy in adulthood. The risk of this happening is minimal, and many doctors believe it is almost zero.

If a child has pre-existing Epilepsy, then a high fever can precipitate a seizure. This is less common in Adults.

Does lack of sleep lead to Seizures?

Yes, definitely.

If you have Epilepsy, you should sleep for 8 hours a day. No excuses, no exceptions.

Lack of sleep may precipitate seizures.

Lack of sleep is a very strong precipitant of Seizures in certain Epilepsy Syndromes, especially Juvenile Myoclonic Epilepsy (JME). If patients with JME don’t sleep well, they get many jerks of the body in the morning. If they are lucky, that is all that happens. Unfortunately, sometimes they also get a whole body generalized seizure.

Lack of sleep can precipitate all kinds of Seizures.

Video-EEG monitoring is an unusual situation when the patient is admitted to the hospital, hooked up to the EEG, and everyone is waiting for a seizure to happen so that it can be studied. If seizures don’t occur by the third day, guess what the doctor and patient conspire to do: Sleep deprivation! The patient sleeps for only 4 hours in the night. Sure enough, many of these patients have a seizure the next day, regardless of their Epilepsy Syndrome.

Does alcohol precipitate seizures?

Excessive intake of alcohol can precipitate seizures in a person with Epilepsy.

Excessive intake of alcohol may precipitate seizures.

Some people who drink huge quantities of alcohol may get seizures, even if they dont have Epilepsy.

Does Stress precipitate Seizures?

Yes, it seems to.

25% of patients with Epilepsy report that Stress precipitates their seizures (Nakken et al. 2005). No one quite understands why this happens; some people believe that hormonal imbalances may play a role.

Stress may precipitate both Epileptic seizures & Non-Epileptic attacks.

Note: Here we are talking about stress precipitating seizures in Epilepsy, due to an increased abnormal tendency of the Brain to have seizures. But, stress can cause seizure-like attacks even when the Brain has NO tendency to have seizures – These are called “Psychogenic Non-Epileptic Seizure-like-attacks” or PNES, described in another article (click here). It is very important to find out if you have Epilepsy worsened by stress OR if you have PNES – both are real problems with good solutions, but the treatments are different.

Considering that 1/4th of patients report a worsening of seizures when they are stressed out, learning stress reduction & relaxation techniques would be an excellent idea.

Certain people may be more susceptible to depression and anxiety at certain times of the year. Some people may need a counsellor or psychiatrist to sort out these issues. You can read more about depression and anxiety and methods to reduce them here:

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Can Menses precipitate Seizures? What are “Catamenial Seizures”?


Some, but not all women, may complain of worsening of seizures around their menses. This worsening is due to the high levels of a hormone called “Estrogen” in the body. These seizures are called “Catamenial Seizures”.

Some women report that they have seizures around menses.

If a lady with Epilepsy is started on anti-epileptics and stops having all seizures, the seizures around Menses may also stop.

In some cases, all seizures except those around Menses may stop. These women may need a slight increase in the dosage of their anti-epileptics during these times, for additional protection. Your doctor may use medications called Benzodiazepines (for example, Clobazam) to provide this extra protection.

In some of these patients, increasing the anti-epileptic dose may not help either. If traditional anti-epileptics don’t work, certain other medications including Acetazolamide or in rare cases a hormone called “Progesterone” may be helpful.

Can missing your Anti-Epileptic medication precipitate Seizures?

Well… Yes, of course.

I think there are two main reasons for not taking medications on time.

1. Many people don’t like taking their anti-epileptic medications.

A lot of people initially have trouble accepting the diagnosis of Epilepsy. This is understandable. It is a somewhat difficult disorder to understand, and the apprehension and complexity of treatments can be overwhelming. This is one of the reasons I wrote this guide. One of the ways we can learn to accept the diagnosis is to increase our knowledge about the disease.

Some patients hate their medications!

Once we accept the diagnosis, the resentment or apprehension while taking Anti-Epileptic medications disappears.

2. Some people forget to take their medications on time.

Please allow me to give you a few tips that I have found helpful with my patients:

  • Take medications at the same time every day: e.g. 9 AM and 9 PM.
  • Use your smartphone to set reminders for this time.
  • OR take your medication immediately after something you do twice every day – e.g. brushing your teeth. Take medicines as the very first thing you do after completing the automatic activity – keep your medications above your washbasin.
    If you brush twice daily, take your pills immediately after you finish brushing.
  • Use a pill-box. Nowadays, you can buy an electronic pill-box which beeps when it’s time to take your medications.
    Using a simple pill box is very helpful. Nowadays, you can even buy pill-boxes with inbuilt alarms!
  • Count your pills at the beginning of the month, and count them again at the end. The difference should be approximately 30 (or 60) tablets.
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

4.6 87 reviews

  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ a year ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ a year ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ a year ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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Noted as one of the best Neurologists in Mumbai

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Ex-Assistant Professor, University of Alabama, USA

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