Lifestyle modification in epilepsy
Lifestyle Modifications
Lifestyle modifications can include:
Adequate sleep: Fatigue is one of the most common seizure triggers, and disrupted sleep can make the brain more vulnerable to misfiring.
Avoiding drugs and alcohol: These can be triggers for seizures in patients with epilepsy. Even one or two drinks can provoke seizures.
Minimizing emotional stress: Although there is not definitive proof that stress causes seizures, those who maintain healthy stress levels have reported that they believe it reduces their risk.
Frequency of exercise: In addition to a range of health benefits, regular exercise can help reduce risk of seizure. However, you should consult your physician before starting a new exercise routine, as some exercise can, rarely, cause seizures.
2. • Specific time of day or night
• Sleep deprivation – overtired, not sleeping well, not getting enough
sleep
• At times of fevers or other illnesses
• Flashing bright lights or patterns
• Alcohol or drug use
• Stress
• Associated with menstrual cycle (women) or other hormonal
changes
• Not eating well, low blood sugar
• Specific foods, excess caffeine or other products that may aggravate
seizures
• Use of certain medication
Seizures triggers
4. • Preclinical studies suggest that caffeine increases
seizure susceptibility.
• In some cases, chronic use of caffeine may protect
against seizures.
• Caffeine lowers the efficacy of several drugs, especially
topiramate.
• It is unclear how these findings in models can be
translated to the clinical condition.
• Until clinical studies suggest otherwise, caffeine intake
should be considered as a factor in achieving and
maintaining seizure control in epilepsy.
Caffeine
5. Driving
• Huge variation from State to State
• Ranges from 3 months to 18 months
seizure-free periods
• Many States have ‘no set seizure-free
period
6. Epilepsy and Driving in Europe
E C Directive Group 1
• 1st Seizure
• Epilepsy
• Provoked seizure
• Sleep seizures
• Other seizures wihout
influence on driving ability
• Other loss of consciousness
• Seizure because of change of
medication
• 6 months
• 12 months
• Varies
• 12 months + no other seizures
• 12 months + no other seizures
• Varies
• 3 mo
Driving
7. Country Law
Seizure-
free
period
Andorra 2 years
Argentina
There are no specific laws prohibiting people with epilepsy from driving. Patients
generally rely on advice from their physicians.[6]
Australia
Patients must be seizure-free for 3–6 months for recently diagnosed seizures, and
for two years for chronic epilepsy.[7][8] Exact laws vary by state or territory.[6]
3 months
to 2 years
Austria
The most common seizure-free period required is 2 years, but in some cases, this
can be extended to 3. Insurance companies are not required to make liability
payments in accidents caused by seizures.[6]
2–3 years
Belgium Seizure-free period required depends on the type of seizure.[6] 1–2 years
Bermuda 1 year
Brazil 1 year
Bulgaria Those who have ever had a seizure are prohibited from driving.[9]
Canada Exact laws may vary by province/territory. See Canada below. 1 year
Central African
Republic
Those who have ever had a seizure are prohibited from driving.[9]
China Those who have ever had a seizure are prohibited from driving.[9]
Croatia 2 years
Cyprus 1 year
Czech Republic[10] Physician may set additional more restrictions (like no night driving), for
professional drivers seizure-free period is 10 years
1 year
Denmark
The national health board is involved in epilepsy cases in determining exact length
of disqualification, which is usually 2 years. Physician input is recommended.[6] 2 years
Egypt 2 years
Estonia
Required seizure-free period of one year for cars and motorcycles and of five years
for trucks and buses[11] 1–5 years
8. • Pace your exercise to avoid getting too tired or
hyperventilation.
• Avoid exercising in the middle of the day during hot weather.
• Try relaxation or slow breathing exercises when anxious or if
you begin to hyperventilate.
Exercise
11. • The British Sub-Aqua Club (BSAC) currently
says that people must be seizure-free for five
years (or three years if seizures only happen in
their sleep) and off AEDs for five years, before
they consider scuba diving.
Scuba diving
19. • Affects up to 5% of people with epilepsy.
• For someone with photosensitive epilepsy triggers can
include:
✓playing video games
✓watching moving computer games
✓watching a faulty television or other light source that
flickers slowly
✓strobe lights.
• The common rate for a flashing light to trigger seizures
is between 3 and 30 hertz (flashes per second).
Photosensitive epilepsy
21. • There are many mechanisms by which video
games may induce seizures. These are:
• Photosensitivity
• Pattern sensitivity
• Emotional and cognitive excitation (excitement or
frustration)
• Proprioceptive stimulation (movement/praxis).
• Fatigue, sleep deprivation and prolonged playing
are facilitating factors.
Video Games induced seizures
23. • The Harding FPA (flash and pattern analyser)
is proprietary software.
• Used to analyse video content for flashing
and stationary patterns which may cause
harm to those who suffer from photosensitive
epilepsy.
The Harding FPA
25. • Installing an anti-glare cover for your computer
monitor
• Changing computer and display screen settings
• Closing window blinds and covering up other
contrasting light or visual patterns
• Opting for natural or warm lighting to avoid
fluorescents
Lifestyle modification in PSE
26. • Fixing any broken, flickering, or malfunctioning
light (fluorescent or otherwise)
• Taking frequent breaks to rest your eyes
• Wearing polarized sunglasses for outdoor
activities to reduce sharp glare.
• Avoid playing when having fatigue and insomnia.
• Photosensitive children should not play electronic
games when they are alone.
Lifestyle modification in PSE
27. • It refers to seizures induced
by television viewing in
photosensitive patients.
• children aged 10–12 years.
• There is a two-fold
preponderance of girls.
• Flickering television set or
at a close distance to the
screen.
Television Epilepsy
28. • Watch TV from a distance
of at least 2 m in a well-
illuminated room
• Use a remote control
• View on a 100 Hz TV.
• Try not to watch for a long
time especially while they
are tired and sleepy.
Lifestyle modification in TV-induced
seizures
31. • Hot water epilepsy (HWE) is
induced by bathing with hot
water usually over 37 degrees
and pouring over the head.
• 2nd most common type of RE
after photosensitive epilepsy.
HWE
32. • Photosensitivity is reported to occur in
approximately 40% of patients with juvenile
myoclonic epilepsy.
• Sleep deprivation
• Alcohol intake
• HV
JME
CAE
35. • Once a day – take the forgotten dose as soon as you remember it;
or
• Twice a day – take the forgotten dose if you remember within six
hours after it was due, otherwise don’t take the forgotten dose
and just take the next dose at the due time.
• It is important that if you miss a dose you do not take twice as
much at the next dose time. Taking a larger dose than normal
could cause side effects.
Medication Schedule