seizure risk reduction

Overview

A seizure is a sudden burst of uncontrolled electrical activity in the brain that can cause changes in movement, behavior, feelings, or awareness. Reducing your risk of seizures means learning what may trigger them and taking steps to make those triggers less likely to cause a seizure.

Seizures are more common than many people think. Around 1 in 10 people will have at least one seizure at some point in their life. Epilepsy, which causes repeated seizures, affects about 1 in 100 people worldwide.

Seizures can happen to anyone, at any age. They are more common in young children and older adults, but people in every age group can be affected. Some people are born with a higher risk, while others develop seizures after a head injury, infection, or stroke.

Symptoms

Common symptoms

• A sudden staring spell, often with no response to sound or touch
• Twitching or jerking movements of an arm or leg that you can't control
• Brief loss of awareness, sometimes called an absence seizure
• A strange feeling or 'aura' before the seizure, like a smell, taste, or déjà vu
• Falling down without an obvious cause
• Making unusual sounds or saying strange words during the seizure
• Feeling confused, tired, or sleepy after the episode

Symptoms in children

• Staring blankly and not responding for a few seconds
• Brief moments of 'daydreaming' that cannot be interrupted
• Sudden dropping of the head or falling suddenly
• Rapid blinking or chewing movements lasting a few seconds
• Arms or legs that suddenly stiffen or jerk

Symptoms in older adults

• Moments of confusion or memory lapses that may be mistaken for dementia
• A sudden feeling of fear, déjà vu, or a strange rising feeling in the stomach
• Falls that seem unwitnessed or lack a clear cause
• Staring spells or brief unawareness
• Twitching of one side of the face or body

Causes

Main causes

• Epilepsy, a brain condition that causes a tendency to have repeated seizures
• High fever, especially in children (febrile seizures)
• Head injury or trauma to the brain
• Stroke or brain tumour
• Infections of the brain, such as meningitis or encephalitis
• Very low blood sugar, sodium, calcium, or magnesium
• Alcohol withdrawal or very heavy alcohol use
• Illegal drug use or withdrawal from certain prescribed medicines
• Lack of oxygen to the brain at birth or later in life

Risk factors

• A personal or family history of epilepsy or seizures
• Previous head injury or brain surgery
• Stroke, dementia, or other brain conditions
• Age — seizures are more common in young children and older adults
• Sleep deprivation or poor sleep quality
• High levels of stress or anxiety
• Drinking too much alcohol or using recreational drugs
• Missing doses of anti-seizure medication if you have epilepsy

When to see a doctor

See a doctor urgently if:

• If you have your first seizure, you should see a doctor as soon as possible to find out why it happened.
• If you have a seizure that is longer, more frequent, or different from your usual pattern, seek medical advice promptly.
• If you have a seizure and you are pregnant, diabetic, or have another chronic condition, get urgent medical review.

Book a routine appointment if:

• If you have epilepsy and are having side effects from your medication, talk to your doctor.
• If you notice new triggers that seem to increase your seizures, even without a seizure happening.
• If you are planning pregnancy or have questions about how epilepsy might affect your life.

Diagnosis

Your doctor will start by asking you and any witnesses what happened before, during, and after the seizure. They will also ask about your medical history, family history, medications, sleep habits, and any possible triggers. There is no single test that confirms a seizure, so your doctor will combine information to make a diagnosis.

Tests that may be done

• Electroencephalogram (EEG) — a painless test that records the brain's electrical activity using small sensors on the scalp
• Blood tests to check for infections, glucose, electrolytes, or liver and kidney problems
• Imaging scans such as a CT scan or MRI to look at the structure of the brain and check for injuries, tumours, or other problems
• Sometimes a neurological examination to test coordination, reflexes, vision, and memory
• Heart tests, such as an ECG, if the doctor suspects a heart-related cause of blackouts

What to expect at your appointment

The diagnosis process usually happens as an outpatient, but you might stay in the hospital overnight for observation or an EEG. Your doctor will help you make a plan to manage your seizures and reduce your risk. You will leave with clear instructions about what to do next and when to seek help.

Treatment

Treatment for seizures depends on the cause. If you have epilepsy, the main goal is to control seizures while minimising side effects. Even without epilepsy, treating the underlying cause — for example, an infection or electrolyte imbalance — can stop seizures. Your care team will tailor treatment to your situation and preferences.

Self-care at home

• Take your prescribed medicines exactly as directed. Missing doses is a common trigger for seizures.
• Keep a seizure diary to track your seizures and possible triggers.
• Aim for a regular sleep schedule and try to get enough rest each night.
• Learn to manage stress with relaxation techniques such as breathing exercises, gentle movement, or mindfulness.
• Limit or avoid alcohol — and if you do drink, tell your doctor so they can guide you safely.
• Wear a medical alert bracelet or inform close friends and family about your condition.

Medical treatments

Anti-seizure medicines (also called anti-epileptic drugs) are the most common first treatment. Your doctor will choose a medicine based on your seizure type, your age, other health conditions, and possible side effects. If the first medicine does not work well, there are other options. Never stop or change your medicine without talking to your doctor first, because stopping suddenly can trigger more seizures. Always ask your pharmacist or doctor if you have any questions.

When is surgery considered?

If medicines do not control seizures well despite trying several options, surgery may be considered. Surgery aims to remove the small area of the brain where seizures start. This is only possible if the seizure focus is safe to remove without causing serious loss of function. Specialists will do detailed tests to see if you are a candidate.

Living with this condition

Living with seizures can feel uncertain, but many people manage well. A daily routine that includes regular meals, sleep, and medication helps. Plan ahead for what to do if a seizure happens — tell people around you, keep a phone nearby, and know how to keep yourself safe during an episode. You do not have to give up the things you love; just learn how to adapt them.

Lifestyle tips

• Try to go to bed and wake up at the same times each day.
• Take prescribed medicines at the same times daily. Use a pill organizer or phone alarm if helpful.
• Avoid flickering lights only if your doctor has identified this as a trigger — not everyone is sensitive.
• Be cautious with activities like swimming, bathing, or climbing — always have someone nearby.
• If you drive, check the rules in your area, as some places require a seizure-free period before you can drive safely.

Diet and exercise

A balanced, regular diet helps keep blood sugar stable and supports overall brain health. Skip long gaps between meals if you are prone to low blood sugar. Regular exercise is safe for most people with seizures, but choose activities wisely — for example, walking, cycling, or gym work with a workout buddy may be better than swimming alone. Always stay hydrated and avoid overexertion that can trigger a seizure.

Mental health and emotional wellbeing

Living with seizures can bring worry, fear, or embarrassment. It is completely normal to feel anxious or down at times. You do not need to face these feelings alone. Talk to your doctor about how seizures affect your mood and daily life. Some people find it helpful to speak with a counsellor or psychologist. Your mental health is just as important as your physical health.

Prevention

You cannot always prevent a first seizure, especially if it is caused by an underlying health condition. But you can reduce your risk of having more seizures by following your treatment plan, avoiding known triggers, getting enough sleep, and managing stress. Staying healthy, preventing head injuries, and treating conditions like high blood pressure and diabetes can also lower your risk.

Vaccines

Some infections that can cause seizures, like meningitis, can be prevented with vaccines. Make sure your childhood and adult vaccinations are up to date. Talk to your doctor about which vaccines are recommended for you.

Screening programmes

There is no routine screening for seizures in the general population. If you have had a head injury, a brain infection, or a family history of epilepsy, your doctor may suggest a check-up. People with certain conditions — such as a previous stroke — should have regular reviews of their overall health to reduce the chance of problems that could lead to seizures.

Complications

If left untreated

• Seizures themselves can sometimes last too long or repeat, which can harm the brain (status epilepticus)
• Falls or uncontrolled movements during a seizure can cause bruises, cuts, fractures, or head injuries
• Drowning is a real risk if a seizure happens in water
• Driving or operating machinery during a seizure can cause accidents
• Repeated seizures can affect memory, learning, or work and social life
• Without treatment, the underlying cause of the seizure (such as an infection or tumour) may not be found and treated

Long-term outlook

The outlook for people with seizures is generally very good. With the right treatment, most people with epilepsy become seizure-free or have many fewer seizures. Many go on to work, drive, have families, and lead full lives. Even after a single seizure, most people do not develop epilepsy. Modern treatment is more effective and better tolerated than ever before. You have good reasons to be hopeful.

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