If you've been diagnosed with epilepsy, it's important to do all you can to lower your risk of seizures. The consequences of uncontrolled epilepsy are serious. Seizures can worsen over time and contribute to anxiety and loss of independence and increase the risk of mental health disorders and accidental death or injury. The best way to avoid seizures is to take antiseizure medication as directed by your neurologist and to report any side effects, especially those that may discourage you from taking the drug. Some side effects can be managed—for example, if the medication makes you sleepy, you may be able to take it at bedtime. If the side effects are intolerable, your doctor may be able to prescribe alternate medication.
To ensure that you take your medication every day, consider using a pill organizer that has a compartment for each day's dose for a week (or month). If you leave for vacation or a business trip without your pills, visit a local pharmacy (if it's part of a chain you normally use) to see if you can get the necessary doses, or call your doctor's office for an emergency prescription.
Some people continue to have seizures even while on antiseizure medication. Healthy behaviors such as getting adequate sleep and reducing stress can help lower the risk of such breakthrough episodes. Keep track of your seizures in a journal, noting when each occurs and what was happening just before the seizure. This could reveal a pattern, such as seizures occurring when you haven't slept enough or have consumed a lot of alcohol or caffeine.
Women may report more seizures around the time of their menstrual periods. A woman should tell her doctor if she is on birth control pills or hormone replacement therapy, because those can trigger seizures.
The U.S. Centers for Disease Control and Prevention (CDC) created a checklist to help people manage epilepsy. It recommends following a well-balanced diet; maintaining a healthy weight; avoiding alcohol, tobacco, and recreational drugs; lowering stress through meditating or listening to music; and staying in touch with family and friends. The CDC also notes that it's important to treat fevers, which can trigger seizures, especially in young children, and to get vaccinated against the flu and COVID-19, as they can cause fevers.
Other safety measures include wearing a helmet while cycling or snowboarding to prevent head injury, which can cause seizures; wearing sunglasses to reduce the likelihood of having a seizure from bright or flickering lights; and lowering the brightness on the TV and computer, not sitting too close to screens, and taking frequent breaks when using the computer or watching television.
For optimum seizure control, be sure to communicate openly with your neurologist about how you're doing and what other options, including surgery, might be available for you, if needed.
Dr. Richerson is chair of the neurology department at the University of Iowa’s Carver College of Medicine in Iowa City.
