This page covers the most common epileptic seizure triggers in children and young people, including poor sleep, missed medication and flickering lights.
What are seizure triggers?
Sometimes, when a young person has epilepsy, certain situations can make a seizure more likely to happen.
These situations are called ‘triggers’ and they vary from child to child. Commonly reported seizure triggers include:
- Overtiredness
- Dehydration
- Fluctuating blood glucose levels
- Illness or fever
- Stress and anxiety
- Overexcitement
- Changes in medication or missed doses
- Hormonal changes during puberty for both boys and girls, including menstruation
- Photosensitivity (flashing or flickering lights), which affects about 3% of young people with epilepsy
- Alcohol or recreational drugs
If you know there are specific triggers that cause a young person’s seizures, this can help you to predict when they’re more likely to happen and take precautions to protect them.
Tiredness and poor or disrupted sleep
A good night’s sleep leaves a person feeling refreshed the next day – and children and young people need more sleep than adults.
But it’s not just about how much sleep – the quality of sleep matters too.
Lack of proper sleep, not enough sleep and disrupted sleep can increase the risk of an epilepsy seizure, and can also lead to more intense, longer-lasting seizures.
So, turn off all devices – TV, mobiles, tablets – one hour before bedtime.
We don’t know why exactly lack of sleep triggers seizures, but there is a definite link between the sleep–wake cycle and seizures.
During the sleep–wake cycle, there are changes in electrical activity in the brain, as well as hormonal activity.
If they consistently have more seizures when they don’t sleep well, it’s important to find out what causes the poor or disrupted sleep – and avoid this in future.
Managing sleepovers
Sleepovers can be an important part of a child’s social development.
But you might be anxious about the child having a seizure at a sleepover.
The best thing to do is to talk to the child about this and discuss it with the other parents so they understand why you’re concerned.
Make sure the parents know:
The child has epilepsy
- What their seizures look like
- What triggers their seizures, e.g. staying up too late and playing computer games for long periods without a break
- How to manage seizures – make sure that they are comfortable about doing this
- About emergency medication and are comfortable with having to give it, if needed
Also make sure the other children at the sleepover:
- Know about the child’s epilepsy
- Understand that they need to get an adult as soon as a seizure happens
It might help to ease into sleepovers.
You could start by having a sleepover at your house. Another option could be to pick up the child at an agreed time before bedtime and then work up to them staying overnight.
Missing anti-seizure medication
You can manage some triggers more easily by making sure the young person takes their anti-seizure medication at the right dose, at the right time, as prescribed by their doctor.
This will help to keep a steady level of the medicine in their blood.
Even one missed dose of anti-seizure medication can lead to a seizure – and stopping medication altogether can be very dangerous.
When changing to a new medication, the medication will be closely monitored. You should report any side effects to your team.
Photosensitive epilepsy
Only about 3% of young people with epilepsy have photosensitive epilepsy – they are sensitive to flashing or flickering lights.
A flicker rate of 5–30 times a second is most likely to cause problems.
Other triggers could include:
- Geometric shapes
- Patterns, such as stripes and checks
- Sunlight reflecting on water
- Light shining through a row of trees
EEG test results will show that there are changes to the electrical impulses in the brain when looking at flashing lights.
Precautions
If the young person has been diagnosed with photosensitive epilepsy, try to stop them coming into contact with any known photosensitive seizure trigger.
If they do, they should not close their eyes, as this can increase the risk of a seizure.
But they should cover one eye with the palm of their hand and look away from the trigger.
There are also other precautions you can take.
If they are playing a video game, sit them in a well-lit room, at least 3m (9ft) from a TV screen or 1m (3ft) from a computer screen. They should also take a 15-minute break every hour.
If possible, they should use a remote control to change TV channels.
If they approach the TV, encourage them to cover one eye with the palm of their hand.
Don’t allow them to play a game on screen when they are tired, as this increases the risk of a seizure.
Encourage the young person to take regular 10-minute breaks following 45 minutes of play and to rest between on-screen games.
Newer TV screens – including LCD and plasma – are less likely to trigger a seizure than older TV screens. This is because they either don’t flicker or have a high flicker frequency.
People may prefer an LCD screen to a plasma screen, as plasma screens tend to be brighter and have a higher contrast, which may increase the risk of seizures.
