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Seizures and Epilepsy: Frequently Asked Questions James A Whitlock, Jr, MD, Northeast Rehabilitation Health Network (page 4 of 4) Page 4 of 4

Seizure activity can be evoked from any brain given the right combination of circumstances. The concept of a "seizure threshold" is based upon the fact that with enough physiological or pharmacologic 'stress', seizures can happen in any mammal (including humans). Individuals differ in what constitutes "enough" of a stress. Some of the factors which influence seizure threshold include genetics (family history), brain trauma (especially "open" or penetrating wounds to brain), a number of medications and drugs (including things not often thought of as "drugs"), body temperature, sleep deprivation and a host of metabolic variables (for example: blood sugar, blood oxygen level, blood minerals, hormones).

There are a number of frequently-overlooked habits which can have a bearing upon seizure risk.

  • Caffeine (found in coffee, tea, over-the-counter 'stay-awake' pills and many carbonated beverages) lowers seizure threshold. This doesn't mean that all persons with or at risk for seizures should abstain completely from anything with caffeine in it. It just means that moderation is probably wise here, especially if prevention of recurrent seizure is proving difficult.
  • Alcohol makes it easier to have a seizure. It does so both as its level rises in the blood stream and as it later falls. It also tends to interact with just about every drug used to treat or prevent epilepsy. Because of its complex effects upon metabolism, body water and mineral balance, sugar metabolism and even sleep, alcohol use should probably be avoided in anyone who has had or is at special risk of seizure.
  • Sleep-deprivation (as in changing from day-shift to night-shift work, or staying up all night to work on a term paper, etc.) probably does much to lower seizure threshold.
  • Combinations of the above are, more likely than not, additive in there effects.

"What are some good sources of additional information regarding seizures and epilepsy?"

  • Your friendly neighborhood physician/neurologist.
  • The Epilepsy Foundation of America (Telephone: 1-800-332-1000) - a trove of educational resources, including bibliographic lists, videotapes, brochures and pamphlets.
  • Engel, J. Seizures and Epilepsy. Philadelphia: FA Davis, 1989.
  • Menkes, JH and Sankar, R: Paroxysmal Disorders. In Textbook of Child Neurology, 5th edition. Baltimore: Williams and Wilkins, 1995.

For lengthier or more reflective comments, feel free to write me at:

Northeast Rehabilitation Hospital
70 Butler Street
Salem, NH 03079

Acknowledgments:
Thanks to Carl Billian, MD, Greg Lipshutz, MD and J. Prochilo for their critical reviews of this work and to N. Druke for kindly helping with illustrations.

Copyright © James Whitlock, MD

From the Northeast Rehabilitation Health Network. Copyright © James Whitlock, MD. Reprinted with permission. All rights reserved. www.northeastrehab.com.


 

 

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From the Northeast Rehabilitation Health Network. Reprinted with permission. All rights reserved. www.northeastrehab.com.
 

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