Risk Management of Epileptic Seizures

Epileptic seizures may arise from a range of causes or triggers that render neurons unstable, thereby lowering the seizure threshold and making seizures more likely to occur:

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Atypical Febrile Convulsions in Childhood (Atypical Febrile Convulsion):

• Febrile convulsions are seizures associated with high fever and are the most common type of seizure in early childhood, particularly between six months and five years of age.

• Typical febrile seizures are generalised, mild, and short in duration. Most children recover completely, with a low risk of recurrent epilepsy later in life.

• Atypical febrile convulsions, however, are more severe, focal, and prolonged, and require immediate medical attention. These may indicate focal brain abnormalities and increase the risk of developing recurrent seizures or epilepsy in later years.

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Congenital or Acquired Structural Brain Abnormalities:

• Congenital brain malformations, vascular malformations, cerebral palsy, or neurodevelopmental disorders such as mesial temporal sclerosis or focal cortical dysplasia can alter brain structure and affect neuronal stability.

• Acquired causes include brain tumours, stroke, and traumatic brain injury.

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Genetic Predisposition:

• Some forms of epilepsy are hereditary.

• Genetic factors may increase the excitability of brain neurons, rendering them more susceptible to abnormal electrical discharges.

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Infections:

• Infections of the brain or central nervous system, such as meningitis, encephalitis, neurocysticercosis, or brain abscess, can damage neural tissue or disrupt its normal function.

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Metabolic and Immunological Disorders:

• Disorders of metabolism or the immune system, such as electrolyte imbalance, hypoglycaemia, or autoimmune encephalitis, may also provoke seizures.

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Other Personal or Environmental Triggers:

• Excessive Excitement, Emotional Stress, Anxiety, or Pressure

  • These factors may lead to increased neuronal firing or hypersensitivity, thereby triggering abnormal brain activity.

• Sleep Deprivation

  • Sleep disturbance is one of the most common triggers of seizures in both children and adults.

  • Adequate, high-quality sleep is essential for maintaining neurological stability.

  • Poor sleep quality, irregular sleep patterns, or chronic fatigue can significantly reduce the brain’s resistance to seizure activity.

• Repetitive Visual Stimulation (Photosensitive Epilepsy)

  • Visual stimuli, such as prolonged exposure to rapidly flashing lights (e.g. from televisions, video games, or strobe lighting), can overstimulate the visual cortex and trigger photosensitive epilepsy in susceptible individuals.

• Alcohol and Drug Misuse

  • Excessive alcohol intake, abrupt withdrawal, or misuse of certain substances such as cocaine and other central nervous system stimulants can alter brain chemistry, impair neural function, and lower the seizure threshold.

• Hormonal Fluctuations, Dehydration, and Electrolyte Imbalance

  • Hormonal changes during menstruation, pregnancy, or menopause can increase seizure activity.

  • Prolonged fasting or dehydration may lead to electrolyte disturbances, such as low levels of sodium, potassium, calcium, or magnesium, which can disrupt normal brain electrical activity and trigger seizures.

• Environmental Toxins and Chemical Exposure, some substances can interfere with brain function and provoke seizures, including:

  • Methanol or alcohol-based solvents

  • Heavy metals such as lead, mercury, or arsenic

  • Certain pesticides and insecticides, particularly organophosphate compounds

  • Inhalation of chemical solvents such as toluene (found in paint thinners and adhesives)

  • Carbon monoxide and other toxic gases

  • Carcinogens and industrial waste by-products