Managing Seizures

Seizures are unpredictable, and this can make you feel like you have little control over your seizures, your condition, or your life in general. Fortunately, however, there are several things you can do that may improve your seizure control and will likely improve your overall health as well. Here are just a few:
- Take your medications as prescribed – Missed medication is the leading seizure trigger. If you are experiencing side effects or can’t afford your medication, don’t take matters into your own hands – talk to your doctor.
- Get enough sleep – Sleep deprivation is another leading seizure trigger. Inadequate sleep also can affect mood, cognitive function, and several other aspects of your health. If you’re having difficulty falling or staying asleep or if you feel tired during the day, talk with your doctor.
- Reduce stress – Stress is the other leading seizure trigger and can lead to heart disease, immune dysfunction, depression, and a number of other health problems. Learning and practicing relaxation and stress management techniques can help to reduce stress. If this isn’t enough, a mental health professional may be needed.
- Keep a seizure diary – Tracking your seizures and writing down how you felt and what happened before, during, and after each seizure can help you and your doctor to identify potential seizure triggers, patterns, and warnings. Identifying triggers can help you to avoid them. Identifying patterns and warnings can help your doctor to adjust your treatment and help you to anticipate and possibly avoid seizures.
- Develop a Seizure Action Plan – Developing a seizure action plan and training those who may witness a seizure to follow this plan can prevent injury, unnecessary medical expenses, and inconvenience. A seizure action plan should describe what types of seizures are experienced and how to respond to each, with seizure first aid and aftercare if necessary. It should also mention seizure triggers, medications taken (including rescue medications and how and when to use them, if necessary), when to call 911, and who to contact. Online seizure first aid certification is available to help those you spend time with recognize and respond appropriately to seizures.
- Plan for Safety – People with epilepsy are at increased risk for injury and death from a number of causes. This includes status epilepticus (prolonged seizure activity), SUDEP (sudden unexpected death in epilepsy), car accidents, drowning, and falls. A balance must be found that allows you to avoid both unnecessary restrictions and unnecessary risks. Talking with your doctor and those around you can help. A safety assessment of your home and your daily routines can also help you to minimize risks.
- Exercise – Vigorous exercise can be a seizure trigger for a very small percentage of people with epilepsy, but for most, it is not. Moderate exercise, on the other hand, has not been shown to be a seizure trigger. There is even some evidence that exercise can improve seizure control and cognitive function. Most importantly, regular exercise improves physical and mental health and reduces risks for a number of chronic diseases.
- Eat a healthy diet – While research has not yet shown many direct links between diet and seizure control (excluding the ketogenic diet), healthy eating will promote wellness and help to prevent chronic illness. It’s also likely to help with seizure control. For some, limiting or avoiding alcohol and caffeine may improve seizure control as well.
Useful Links:
- Learn & Share Conference Call - Epilepsy: Understanding and Managing Risks; David Burdette, MD
- Learn & Share Conference Call - Aging Well With Epilepsy: Adriana Tanner, MD
- Learn & Share Conference Call - Epilepsy Self-Management: Toya Malone, MD
- Learn & Share Conference Call - Seizure Triggers: Identification and Management; Shailaja Gaddam, MD
- Learn & Share Conference Call - Stress Management & Relaxation Techniques: Andrea Thomas, MA, LLP
- Learn & Share Conference Call - Sudden Unexpected Death in Epilepsy (SUDEP): Orrin Devinsky, MD; Kellie Jankowski, GC-C
- Learn & Share Conference Call - Management of Status Epilepticus: Donald Phillips, MD; Nikesh Ardeshna, MD
- Learn & Share Webinar - Smartphone Apps and Online Tools for Managing Epilepsy: John Hixson, MD; Patty Shafer, RN, MN
- Learn & Share Conference Call - Shared Decision Making for Improved Epilepsy Care: Bev Crider
- Medication Compliance
- Sleep and Epilepsy
- Stress and Epilepsy
- Epilepsy and Exercise
- PROGRESS Toward Wellness - phone-based epilepsy self-management program for adults
- WebEase - an interactive, online self-management program for people with epilepsy
- PATH (Personal Action Toward Health) - a six-week chronic disease self-management program offered at multiple times and locations across Michigan
- Seizure Tracking/Epilepsy Self-Management apps - My Seizure Diary ; Seizure Tracker ; Texting 4 Control ; Epilepsy Health Storylines; Birdhouse for Epilepsy; Epsy
- Seizure Detection & Alert Devices - SmartWatch Inspyre by SmartMonitor; Embrace2 by Empatica; Brain Sentinel SPEAC System; Seizario; SeizAlarm; SAMi Sleep Activity Monitor; Emfit Movement Monitor; Medpage BMA-01
- Organizations that may provide financial assistance for devices and/or seizure response dogs: Danny Did Foundation, Chelsea Hutchison Foundation, JoshProvides, Children's Special Health Care Services
- Developing Seizure Preparedness Plans
- Rescue Medications for Epilepsy
- Epilepsy and Safety
- Directory of Seizure Response Dog Trainers and Organizations
You and Your Healthcare Team
Your healthcare team (i.e. neurologist, primary care physician, nurses, social worker, etc.) plays a major role in the management of your epilepsy. As such, it’s important to make sure that your healthcare team is meeting your needs. Is your neurologist asking you the right questions, answering all of your questions, and taking your concerns seriously? Does your neurologist have the right level of experience in diagnosing and treating epilepsy? Does the hospital or clinic you attend have the necessary staff, services, and technology and provide the full range of treatment options? If the answer to any of these questions is “no,” you may want to consider seeking care elsewhere.
You play an important role on your healthcare team as well. By giving your healthcare providers honest and complete information, being prepared for appointments, and following the prescribed treatment regimen, you will increase the chances of successful treatment. For more information, see Getting the Most Out of Medical Appointments.
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Healthcare Access & Insurance
Medication, doctor visits, diagnostic tests, and other procedures can cost a lot of money. If you don’t have insurance or your insurance is inadequate, you may be faced with difficult choices (e.g. to pay your rent or have the test your doctor recommends). Even if you have good insurance, you may live far away from an epilepsy specialist, or your insurance might limit your choice of provider.
While Epilepsy Foundation of Michigan can’t provide direct financial assistance with healthcare costs, we can connect you with patient assistance programs, free clinics, and other resources to help you get the care and treatment you need. We can also help you prioritize your needs while working with you to develop a plan to get health insurance. In addition, our Learn & Share Conference Calls program offers opportunities to talk with epilepsy specialists, even if there are none in your local area.
Useful Links:
- Partnership for Prescription Assistance – helps connect patients to prescription assistance programs for which they are eligible
- NeedyMeds – lists resources to help with medication costs
- World Medical Relief Prescription Program – (click on “Prescription Programs” under “Services”) People without prescription coverage who meet income eligibility requirements can pay $8.30 for a 30-day supply of medication. Most antiepileptic medications (in generic form) are available.
- Michigan Drug Prices.com – a program that allows you to compare drug prices (including most antiepileptic drugs) at different pharmacies in your area
- GoodRx - website that allows you to compare drug prices at different local pharmacies and offers discounts and coupons
- National Association of Boards of Pharmacy – shopping online for medications can sometimes help you find lower prices; NABP provides a list of recommended online pharmacies that meet standards for safety and quality
- Michigan Department of Insurance and Financial Services - can assist with the complaint process when health insurance providers violate consumer rights or deny coverage; can also assist with auto insurance, financial planning, and more
- Health Insurance Consumer Assistance Program - Michigan government service that provides free help to anyone looking for Health Insurance information. HICAP can help with questions, worries, disputes, and complaints related to private or public health insurance.
- HealthCare.gov - includes info on the Affordable Health Care Act and a tool to help you find insurance options
- Healthy Michigan Plan - an expansion of Michigan's Medicaid program that covers adults whose income is at or below 133% of the federal poverty level
- Medicare.gov
- Michigan's State Health Insurance Programs
- Children's Special Health Care Services
- Michigan County Health Plans
- Find a Federally Funded Health Center – affordable healthcare for the uninsured and underinsured
- Find a Free Clinic
- healthinsurance.org – health insurance information and free quotes
- Learn & Share Conference Call - Public Benefits & Supports for Adults with Epilepsy; Tom Kendziorski, Esq.
- Learn & Share Conference Call - Navigating Health Insurance; Amy Miilu, Department of Insurance and Financial Services
Special Considerations for Women
Women with epilepsy face a number of unique challenges. In the general medical community, understanding of these challenges is still limited. The following are some issues that physicians treating women with epilepsy should understand and be able to address:
- Female reproductive hormones often influence seizure patterns. In some women, seizure frequency increases at certain times during the menstrual cycle. For others, puberty or menopause can be associated with changes in seizure patterns. There are a number of treatment strategies for dealing with hormone-related seizures.
- Women with epilepsy are at increased risk for several reproductive disorders, including polycystic ovary syndrome, early menopause, and irregular ovulation.
- Antiepileptic medications can decrease the effectiveness of birth control pills.
- Antiepileptic medications can increase the risk of osteoporosis (bone loss). Additional bone density screening and calcium and vitamin D supplements may be needed.
- Women with epilepsy can and do become pregnant and have healthy babies. There are, however, special issues regarding medications, seizure prevention, breastfeeding, and parenting that should be considered prior to having a baby.
- Psychogenic nonepileptic seizures are more common in women than men (about 70% occur in women). There is still misunderstanding in the general medical community regarding psychogenic seizures and how they differ from epileptic seizures.
If the doctor treating your epilepsy is not familiar with these issues or is dismissive toward them, consider seeing a specialist who takes your concerns seriously.
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