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In some cases, stress can cause a seizure. However, how stress-induced seizures develop can depend on many factors, such as the type of seizure disorder you experience.It’s rare for stress to trigger an epileptic seizure, but there is a complex association between stress and seizures.

Many stressful situations are unavoidable, but there are steps to manage them and improve your quality of life.

Read on to learn how stress can cause a seizure and how stress relates to seizure types. Also, this article details seizure diagnosis, stress and related conditions, and examines treatment and management.

Can stress cause seizures?

Stress can trigger seizures in some people who already experience epilepsy. Research from a 2021 study suggests a link between long-term elevated stress and more frequent seizures. However, the research shows a complicated association with many potential factors, including inflammation in the brain.

Experiencing stress or stressful emotions like fear, anxiety, or anger can affect hormones and neurotransmitters in the entire body, which can impact nerve cell excitability in the brain. Brain excitability can sometimes trigger epileptic seizures.

However, emotional stress does not cause epileptic seizures in those who have never experienced them, and it’s not a known cause of epilepsy.

Stress can be the underlying cause of a psychogenic nonepileptic seizure (PNES). PNES differ from epileptic seizures — they do not result from electrical brain activity. They are psychiatric and can cause severe distress.

Provoked seizures, like from physical injury or illness, are not known to be caused by emotional stress.

Contact your doctor if you are concerned about the impact of stress on your health or feel your treatment is ineffective.

How stress may cause seizures

Researchers are unsure how stress induces PNES and epileptic seizures. It may occur because of stress resulting in the release of hormones that impact the brain and nervous system. Areas of the brain involved in seizures may also interact with areas involved with regulating emotions.

Stress may also indirectly trigger seizures. For example, stress may impact sleep. Poor sleep quality is a common epileptic seizure trigger.

In addition, a stressed person might skip meals and become hypoglycemic or skip epilepsy and diabetes medications. They may also drink alcohol.

PNES explained

During an epileptic seizure, the brain experiences abnormal electrical activity. Neurons create as many as 500 signals in 1 second during a seizure episode.

By contrast, PNES are not the result of atypical electrical brain activity. Instead, they may result from underlying psychiatric disorders and high-stress traumatic situations. People with PNES tend to have a history of trauma, abuse, or psychiatric conditions.

However, it’s possible to experience both epilepsy and PNES. A 2021 study suggests that around 10–30% of people with PNES also have epilepsy.

PNES symptoms can be difficult to distinguish from epileptic seizures. About 20–40% of people initially admitted to epilepsy monitoring units later received a PNES diagnosis.

Doctors and neurological specialists may be able to help you receive an accurate diagnosis.

Panic attacks vs. seizures

Anxiety and emotional stress can sometimes cause a panic attack.

A panic attack is a sudden onset of intense fear or anxiety. Panic attacks can also cause physical symptoms, such as:

  • rapid heartbeat
  • trembling
  • sweating or chills
  • stomach and chest pain
  • weakness or fainting
  • tingling or numbness
  • difficulty breathing or swallowing
  • breathing too fast, also known as “hyperventilation”

Symptoms of a panic attack and some seizure types can be similar. As a result, there is a chance you may initially receive an incorrect diagnosis, or you may attribute your symptoms to a different disorder.

Symptoms of anxiety can also be present with both conditions. Both a seizure and a panic attack can appear without warning.

However, a panic attack that does not trigger a seizure will not cause epileptic electrical brain activity. Diagnostic testing can help a doctor see this and provide you with the correct diagnosis.

A person who is very anxious or self-conscious about having a seizure might also experience a panic attack due to that anxiety. There is treatment for panic attacks, and it can be effective. People with panic attacks can stop having them with treatment, such as cognitive behavioral therapy.

Some seizures can be very quick, lasting only a few seconds to minutes. Panic attacks may last between 5 minutes and 1 hour.

If you notice someone having symptoms for 5 minutes or more, and you suspect it could be a seizure, call 911. Prolonged seizures can be dangerous to health.

Can panic attacks cause seizures?

Hyperventilating can trigger a seizure in people with epilepsy, although the reason is unknown.

However, panic attacks are also not a known cause of epilepsy in people who do not already have the condition.

Panic attacks and hyperventilation can also trigger episodes in people with PNES. A 2018 literature review suggests that 17–83% of people with PNES also reported experiencing panic attacks.

Also, traumatic events that can cause a panic attack may contribute to the development of PNES in those who do not have it.

Not everyone‘s seizure triggers and causes are the same

While stress and other specific factors may trigger or cause seizures in some people, it may not be the same for everyone.

Many types of seizures can have many different causes. Often, seizures occur due to the effects of more than one factor. Stress is not the only factor that contributes to a seizure.

Epileptic seizures, provoked seizures, and PNES may all develop due to genetic and environmental factors.

Also, some people who experience stress may never experience a seizure. Some people with seizures may not experience much stress or manage it well.

Diagnosis

A neurologist will ask for specifics about the seizure. Having someone who witnessed the seizure with you during your doctor’s visit can be helpful. It is important to communicate your stress levels leading up to the seizure.

A doctor may test for other causes and seizure types. Tests can include:

  • blood tests
  • EEG monitoring
  • imaging scans, such as an MRI

Monitoring and imaging tests such as an EEG can indicate whether the seizure occurred due to electrical brain activity or whether the seizure may be a PNES.

Treatment and management of stress

According to the Epilepsy Foundation, no definite evidence proves that managing stress helps seizures. However, many people report they believe that managing stress does reduce their risk of seizures.

A 2021 study on the impact of stress on epilepsy also suggests that management techniques might improve quality of life and reduce seizure frequency in people with epilepsy.

Also, treatments to manage stress and address past traumas are the main treatment method for PNES.

Consider trying various stress management techniques to learn which ones work best for you. Some methods include:

  • therapy or counseling, such as cognitive behavioral therapy or eye movement desensitization and reprocessing therapy
  • mindfulness or meditation
  • deep breathing or yoga techniques
  • exercise
  • eating a balanced diet
  • antidepressant or anti-anxiety medications

Other lifestyle approaches that may help you manage stress include:

  • preparing for stressful tasks
  • prioritizing important tasks
  • switching to a lower-stress job, if possible
  • setting boundaries or physically removing yourself from stressful situations
  • spending time with people who put you at ease and avoiding people who add stress to your life
  • scheduling time for rest and self-care

Treatment and management of seizures

Antiseizure medications are an important treatment for controlling all epileptic seizures, including stress-induced epileptic seizures. The World Health Organization (WHO) estimates that up to 70% of people with epilepsy worldwide could experience life seizure-free with antiseizure medications.

However, if medications do not control your seizures, there are other treatment options. Additional treatment options for epileptic seizures include:

  • surgery
  • neurostimulation
  • ketogenic diets

Knowing your seizure triggers and avoiding them can also help manage the frequency. Consider keeping a record of seizure episodes and the conditions surrounding their occurrence.

Principal treatments for PNES involve psychiatric therapies such as CBT and medication for mental health conditions.

Summary

Stress can trigger epileptic seizures and PNES. Also, stress can be an underlying cause of PNES in people who do not have the condition. However, it’s unlikely stress alone can induce seizures or an epileptic seizure in someone who does not already have epilepsy.

Treatment for epileptic stress-induced seizures can include antiseizure medication. PNES can be treated with psychiatric therapies. Reducing stress through management techniques such as meditation, counseling, and self-care may help prevent a stress-induced seizure episode.

 

Source: healthgrades.com, Heidi Moawad, M.D., Tessa Cooper

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