Stick to a medication schedule.
“The number one reason for breakthrough seizures is missed doses of medication,” says Sheryl R. Haut, MD, director of the adult epilepsy program at Montefiore Medical Center at Albert Einstein College of Medicine in the Bronx, NY. “Set an alarm or use a weekly pillbox to remind yourself to not miss a dose.”
Don't mix drugs.
For people with epilepsy, certain stimulants, antidepressants, antihistamines, and narcotics can increase their susceptibility to a seizure, says Rebecca E. Fasano, MD, associate professor of neurology in the epilepsy division at the Emory University School of Medicine in Atlanta. Before using these medications, talk to your doctor and let him or her know you have epilepsy.
Identify your triggers.
Keep a diary to record when and where your seizures occur and try to identify patterns. For example, if bright or flashing lights are triggers, avoid them. If you're susceptible to cluster seizures in high-risk situations, you may be able to take a rescue medication preventively, says Dr. Haut. Or your physician could prescribe an additional medication for short-term use. The Epilepsy Foundation offers a free tool called My Seizure Diary to help people track their seizures, recognize triggers, and manage medications.
Find the right diet.
The basics of good eating—healthy, minimally processed foods like fruits, vegetables, whole grains, nuts, and lean proteins—apply to people with epilepsy as they do to everyone else. For some people with drug-resistant epilepsy, a ketogenic diet—which is high in “good” fats and protein and low in carbohydrates—or a modified Atkins diet (similar to keto but less restrictive) helps control seizures, says Shawniqua Williams Roberson, MD, assistant professor of neurology and of biomedical engineering at Vanderbilt University in Nashville.
Sleep tight.
For many people with epilepsy, insufficient sleep triggers seizures. One study, reported in Epilepsy Research in 2016, found that in the 24 hours before their seizures, people with epilepsy got an average of one hour less sleep than usual. Be sure to get the amount of sleep you need every night.
Drink less alcohol.
Excessive drinking and the withdrawal that follows are highly risky, says Jacqueline French, MD, FAAN, chief medical officer of the Epilepsy Foundation. According to a 2018 issue of Epilepsy Research, while moderate alcohol intake wasn't a cause of seizures in a study's participants, even occasional binge drinking was associated with less seizure control.
Manage stress.
A study in a 2016 issue of Epilepsy & Behavior found that people with uncontrolled epilepsy had higher perceived stress levels and more sleep disturbances than those with well-controlled epilepsy. Exposure to high levels of stress results in the release of stress mediators—such as glucocorticoids and neuropeptides—throughout the brain, particularly into the hippocampus, a region that's especially prone to seizures, according to research in a 2017 issue of Trends in Neurosciences. To reduce the effects of stress, consider relaxation techniques such as progressive muscle relaxation (PMR), yoga, biofeedback, or deep breathing exercises. A 2019 study in Current Opinion in Neurology conducted by Dr. Haut and colleagues reviewed the research on behavioral interventions in epilepsy and found that mindfulness techniques and PMR were particularly beneficial in reducing seizure frequency.
Exercise regularly.
The exercise-induced release of beta-endorphins and other substances may inhibit abnormal electrical activity in the brain. Plus, “exercise is important for general health, well-being, and mood,” says Dr. French.
