Once seizure triggers have been identified, it's time to develop a plan on what to do to lessen the chance that these will affect your seizures, and ideally improve your seizure control. There's no magic solution to this. Just like triggers may vary from one person to the next, so too will plans for how to manage triggers. While some doctors or nurses may tell you to avoid all triggers by making major changes in your lifestyle, this advice is not always very easy to follow. It's usually better to make plans to modify your lifestyle or environment in response to triggers, rather than trying to greatly restrict your lifestyle. Making lifestyle modifications is something that can be done only by you and your family, but you'll want help and ideas from your health care team. Here are a few questions to ask yourself first.

Assessing your readiness

• What are the benefits of modifying my lifestyle/environment compared to the risk of seizures?
• What are the benefits of participating in activities as compared to the risks of restricting my life?
• Are there specific behaviors or lifestyle changes that I could make?
• Are there changes in my environment that could be made?
• Do the likely triggers happen often enough so that changes in my lifestyle would make a difference? (Just because something that occurs a few times around the time of a seizure doesn't mean it's a consistent trigger or that changing it may make a difference).
• Am I willing to make changes in my lifestyle or environment?
• Am I ready to make changes? Making changes isn't easy and you need to find a time to make it workable for you. For example, when life is real stressful, maybe that's not the best time to make major changes in your life!
• Do I have the information, resources and 'know how' to modify my lifestyle?
• What are my priorities and goals? Is controlling my seizures a priority? If so, then finding a way to manage triggers would be important. If you've noticed that stress is a major factor, can you devote time to learning stress management techniques and make that a priority?

Developing a plan for trigger management

Once you've answered the questions above, you're ready to start making plans. Make an appointment with your doctor, nurse or another health care professional recommended by your doctor who can help you look at your triggers, lifestyle and environment. Then for each factor you've identifed as a possible trigger, look at what could be done to lessen the chance it will bother you or trigger your seizures. For some triggers, this may be easy. For example, if drinking alcohol is associated with more seizures, then can you change this habit and stop drinking? Or does it mean that you need to 'moderate' your intake so you have only one glass of beer or wine instead of more? If you have photosensitive epilepsy, there are very specific suggestions that can help lessen the chance that photic stimulation will bother you. Some of these may be changing your own behavior, such as sitting farther back from a television or video game, or not going to nightclubs where flashing lights or strobe lights are commonly found. Other changes may be environmental - consider your destination when planning vacations or trips so you're not going to be exposed to flashing lights or patterns.

However, managing triggers can get more complex if you have problems with sleep or stress, because often these triggers go together. Sleep problems can be a result of stress, and stress can lead to sleep problems. So developing a plan to manage these triggers will likely require you to tackle both issues. For specific ideas and tips for trigger management, look at the following pages and links in this section.

Consider when to manage triggers

Some people notice that specific triggers bother them all the time, while others find that the triggers are problematic only during their 'high-risk' times. Think about these high-risk times when you are developing your plans. It's hard to change things all the time, but if you know you're susceptible when you are sick, sleep deprived, or near your menstrual period (for women with menses), then keep possible triggers to a minimum during these times and make sure you don't miss any medicines when you're at greater risk of seizures. It's often helpful to use your seizure calendars to mark off your high-risk times. Then as you get closer to those dates or times, you can pay particular attention to your trigger management plans! If you make it through the high-risk time without seizures, you'll know your plans worked! If you still had seizures, then you'll need to look and see what else may have been going on. Then talk to your doctor or nurse about what else you can try next time.

Record your plans

Ideally, by now you've had a chance to develop a seizure preparedness plan. This plan, while helping with seizure first aid, can also help you keep track of what your triggers are, and what you can do about them. It will also let others know about your triggers so they can help you with your plans. If you haven't yet made a preparedness plan, you can find one in the Resource Kit or click here.

Topic Editor: Steven C. Schachter, MD and Patricia O. Shafer, RN, MN.
Last Reviewed: 9/30/08