seizure flare ups

Overview

A seizure flare-up is a temporary period when seizures happen more often, last longer, or feel different from what is usual for a person. It is not a separate disease, but a pattern that can happen as part of a seizure condition. It can last for a few hours to a few weeks, and with good care it often settles down.

Yes. Seizure flare-ups are common for many people living with epilepsy. A flare-up does not always mean that the condition is getting worse, but it should be discussed with a healthcare provider.

Seizure flare-ups can affect anyone who has seizures, but they are most commonly seen in people with epilepsy. They can happen at any age, from children to older adults, and may vary in severity and duration.

Symptoms

Common symptoms

• Staring spells or brief pauses in activity
• Uncontrollable jerking or shaking of the arms, legs, or body
• Feeling strange sensations, sights, sounds, or smells before a seizure
• Loss of awareness or confusion during or after an episode
• Sudden falls without a clear reason
• Lip-smacking, chewing, or fumbling movements

Causes

Main causes

• Missed or changed seizure medication
• Lack of sleep or irregular sleep patterns
• High stress or strong emotions
• Illness with fever, such as a cold or infection
• Hormonal changes, such as during a monthly period or pregnancy
• Missed meals or dehydration
• Alcohol use or alcohol withdrawal
• Flashing lights, in some people

Risk factors

• Having epilepsy or a history of seizures
• Previous brain injury, stroke, or brain surgery
• Conditions that affect how medicines are absorbed or removed from the body
• Living with chronic health conditions that affect sleep or stress levels
• Taking certain medicines that can lower the seizure threshold
• Life changes such as pregnancy or menopause

When to see a doctor

See a doctor urgently if:

• Seek same-day advice if you have more seizures than usual, your seizures are lasting longer than your typical pattern, or the person is taking longer than normal to recover.
• Do not wait for a routine appointment if you are worried or if the change happens suddenly.

Book a routine appointment if:

• If you have a seizure condition, book a routine review with your healthcare team if you notice a mild change in seizure frequency or pattern that does not feel urgent.
• This is also a good time to discuss your seizure diary and any possible triggers.

Diagnosis

To understand a seizure flare-up, a doctor will take a detailed history. They will ask you (or someone who saw the events) to describe exactly what happened before, during, and after a seizure. They may also ask about sleep, stress, illness, medicine changes, and any other new factors.

Tests that may be done

• Electroencephalogram (EEG), a recording of brain activity
• Blood tests to look for infection or other imbalances
• Magnetic resonance imaging (MRI) or computed tomography (CT) scan of the brain
• Video monitoring or a detailed seizure diary review

What to expect at your appointment

The doctor may refer you to a specialist in brain and nervous system conditions to review your treatment plan. They will want to know if the flare-up has a clear cause, such as infection, sleep deprivation, or another trigger. You will be involved in building a plan that feels safe and practical for your daily life.

Treatment

The goal of treatment is to shorten the flare-up, prevent harm, and get seizures back to their usual pattern. Treatment depends on the likely cause. Sometimes simply treating an infection, improving sleep, or adjusting daily routines is enough. Other times, the specialist may recommend a temporary change in medication.

Self-care at home

• Keep a seizure diary to spot patterns and triggers
• Stay as consistent as possible with sleep and meal times
• Avoid known triggers such as missed sleep, stress, or flashing lights if that applies
• Have a clear safety plan and tell the people around you what to do
• Do not stop or change your seizure medicine without speaking to your doctor

Medical treatments

Medical treatment should always be directed by a qualified healthcare provider. Depending on the situation, a doctor may adjust the current seizure-control medicine, arrange a short-term treatment to stop the flare-up, or treat an underlying illness that is triggering seizures. In some cases, a specialist may prescribe a short course of a medication used only for emergencies during a seizure flare-up. No medicine should be started, stopped, or changed without medical advice.

When is surgery considered?

Surgery is not a treatment for a typical flare-up. It may be considered in a few carefully selected cases where seizures continue despite medical treatment and a clear focus in the brain can be identified. This decision is made by a specialist team after thorough testing.

Living with this condition

Living with a seizure flare-up can be stressful, but focusing on small daily routines can help you feel more in control. Keep a simple seizure diary, tell a friend or family member about your plan, and make sure trusted people know how to help if you have a seizure. Wear a medical ID or carry a card that mentions your seizure condition, if possible.

Lifestyle tips

• Aim for regular sleep, including going to bed and waking at similar times
• Find ways to manage stress, such as breathing exercises, walking, or talking with someone you trust
• If you drink alcohol, talk to your care team about how much is safe for you
• Avoid risky activities during a flare-up, such as driving, swimming alone, or climbing

Diet and exercise

Eating regular meals and drinking enough water can help keep your body steady. Most people with seizure conditions can exercise, but it is wise to avoid extreme dehydration or overheating. Check with your healthcare team about any activity restrictions, especially during an active flare-up.

Mental health and emotional wellbeing

Seizure flare-ups can bring fear, frustration, and worry. It is completely normal to feel this way. If you feel overwhelmed, anxious, or low, talk to your healthcare team about support such as counselling. If you ever have thoughts of harming yourself or feel you are in crisis, reach out immediately to your local crisis support or emergency number—you do not have to face this alone.

Prevention

Seizure flare-ups cannot always be prevented, but many can be reduced by identifying and managing triggers. Following your usual treatment plan, keeping regular sleep patterns, and taking care of your general health are the strongest steps you can take.

Vaccines

Illness and fever can trigger seizures for some people. Staying up to date with routine vaccinations—as recommended by your local health service—may help reduce infection-related flare-ups.

Screening programmes

There is no routine screening test for seizure flare-ups. If you have epilepsy, regular reviews with your healthcare team are the best way to monitor your seizure control.

Complications

If left untreated

• Injuries from falls or accidents during seizures
• Prolonged seizures that do not stop, which need urgent medical help
• Drowning or injury from bathing or swimming
• Increased confusion or memory problems after repeated seizures
• Social isolation or fear of going out

Long-term outlook

With the right treatment and trigger management, most seizure flare-ups settle within days or weeks. Many people continue to live full, active lives and maintain good seizure control. You are not alone in managing this, and seeking help early gives you the best chance of a safer recovery.

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