Epilepsy is a brain disorder that causes people to have seizures. The seizures may be mild or severe. Multiple variables can cause an epileptic seizure, with stress and anxiety being two of the most commonly self-reported seizure triggers.

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Causes of epilepsy and triggers for seizures

Causes of epilepsy

For about 50% of the people with epilepsy, no cause is known. In the other half, the condition may be mapped to various factors, including:

  • Genetics. Epilepsy runs in some families, indicating there’s likely a genetic component.
  • Head trauma. Being in a car accident or suffering another traumatic injury can cause epilepsy.
  • Brain conditions. Conditions that cause damage to the brain, like brain tumors or stroke, can cause epilepsy. For adults over the age of 35, stroke is a leading cause of epilepsy.
  • Infectious diseases. Meningitis, AIDS and viral encephalitis can cause epilepsy.
  • Prenatal injury. In utero, an infection in the mother, poor nutrition or oxygen deficiencies can give the baby brain damage that can result in epilepsy or cerebral palsy.
  • Developmental disorders. Epilepsy can sometimes be associated with autism and neurofibromatosis.

What triggers epileptic seizures?

Besides stress and anxiety, other triggers include:

  • Alcohol or drug use.
  • Fevers or other illnesses.
  • Flashing bright lights or patterns.
  • Menstrual cycle or other hormonal changes.
  • Not eating well or low blood sugar.
  • Sleep deprivation – overtired, not sleeping well, not getting enough sleep.
  • Specific foods, excess caffeine or other products.
  • Specific time of day or night.
  • Use of certain medications.

Types of epileptic seizures

There are three types of seizures: focal onset, generalized onset and unknown onset.

  • Focal onset seizures. Formerly known as partial seizures, focal seizures tend to start in one area or group of cells in one side of the brain.
  • Generalized onset seizures. Generalized onset seizures start on and affect both sides of the brain simultaneously. This includes seizure types like tonic-clonic, absence and atonic.
  • Unknown onset. When the beginning of a seizure is not known, it’s called an unknown onset seizure.

Main phases of an epileptic seizure

All seizures have three phases: beginning, middle (ictal) and ending (post-ictal).

Beginning phase

The beginning phase has two parts: the prodrome stage and the aura.

  • In prodrome, people get signs and symptoms that tell them a seizure is on its way, sometimes hours or even days before the seizure starts.
  • In the aura, people experience the early part of the seizure, including certain symptoms like nausea, headache or panic.

Not all people experience the prodrome stage or aura during the beginning phase.

Middle (ictal) phase

The middle phase is called the ictal phase and is the most active part of the seizure when intense electrical activity is firing in the brain. It’s defined as the time from the first symptom to the end of the seizure.

Ending (post-ictal) phase

The final stage marks the end of the seizure and is the time people will begin to feel the physical after effects. It’s also when recovery starts to take place. The amount of time it takes to recover will depend on the type of seizure and the part of the brain involved.

Diagnosing epilepsy

Your doctor will evaluate you for epilepsy if you’ve had more than two seizures in your lifetime.

To start the diagnosis, your doctor will review your full medical history and the events leading up to the seizure. They will want to know of any symptoms that appeared pre-seizure, like migraine headaches, sleep disorders and extreme psychological stress.

Next, your doctor will use lab tests to rule out other conditions that can cause seizure-like activity. The tests may include:

  • An electroencephalogram (EEG) measures your brain waves during a seizure and can help your doctor diagnose the type of seizure.
  • A spinal tap to rule out infection.
  • A toxicology screening to test for drugs, poisons or toxins.
  • Blood testing to check for electrolyte imbalance.

Imaging scans such as a CT scan or MRI scan can also be effective in providing a clear picture of the brain. These scans allow your doctor to see abnormalities like blocked blood flow or a tumor.

Treatments for epilepsy

Focusing on the cause

The best way to treat epilepsy is by treating the cause of the seizures. In doing so, you may be able to prevent future seizures from occurring. Treatment options include:

  • A ketogenic diet that focuses on high fats and low carbs.
  • Medications, including narrow-spectrum and broad-spectrum anti-epileptic drugs (AEDs).
  • Surgery to correct brain abnormalities.
  • Vagus nerve stimulation (VNS).

Medications for epilepsy

Choosing the right anti-epileptic drug (AED) depends on several factors:

  • Age.
  • Chance of becoming pregnant.
  • Frequency of seizures.
  • Lifestyle.
  • Types of seizures you have.

There are two types of medications for epilepsy: narrow-spectrum AEDs and broad-spectrum AEDs.

  • Narrow-spectrum AEDs are designed for specific types of seizures and are often used to treat or prevent seizures that occur in a specific part of the brain on a regular basis.
  • Broad-spectrum AEDs are the best treatment option if you have more than one type of seizure happening in more than one part of the brain.

Frequently asked questions (FAQs) about epilepsy

What are the first signs of a seizure?

Early warning signs of a seizure can include:

  • An out of body sensation.
  • Change in vision.
  • Dizziness.
  • Feeling of being sick to your stomach.
  • Headache.
  • Jerky movement of the arms and legs that may cause you to drop things.
  • Sudden feeling of fear or anxiousness.
What is a mini seizure?

A mini seizure (also known as a simple partial seizure) affects only one area of your brain, doesn’t cause unconsciousness and typically only lasts 30 seconds to a minute.

Does epilepsy run in families?

In some cases, yes. According to the Epilepsy Foundation, if a person’s mother, father or sibling has epilepsy, their risk of developing epilepsy by the age of 40 is less than 1 in 20.

Do seizures damage the brain?

Depending on the kind of seizure, brain damage can occur. Longer seizures have been shown to injure the brain, while brief, more isolated seizures can possibly cause the loss of specific brain cells.

Does epilepsy worsen with age?

There is an increased risk for seizures for adults with epilepsy over the age of 60.

Can someone with epilepsy drive a car?

Every state has their own requirements on allowing people with epilepsy to drive a car. In general, drivers must show proof that they’ve been seizure free for a specific period of time and submit a physician’s evaluation of their ability to drive safely.

What foods should you avoid if you have epilepsy?

None. There isn’t any supporting evidence that a specific type of kind of food consistently triggers seizures in people with epilepsy.

Is epilepsy considered a disability?

Epilepsy is considered a medical condition, not a disability. However, adults with epilepsy may be eligible for Social Security disability benefits.


Center for Disease Control and Prevention (CDC). Frequently Asked Questions About Epilepsy (https://www.cdc.gov/epilepsy/about/faq.htm)

National Institute of Neurological Disorders and Stroke (NINDS). Epilepsy (https://www.ninds.nih.gov/health-information/disorders/epilepsy)

MedlinePlus: National Library of Medicine. Epilepsy (https://medlineplus.gov/epilepsy.html)