Can Stress Cause Seizures?

Seizures can be caused by several different triggers, while seizure-like episodes, also called pseudo-seizures, are commonly associated with a variety of psychological conditions, including stress.

Learn more about seizures, distinguishing the differences between seizures and pseudo-seizures, and the impacts of stress.

Seizures are sudden surges of electrical activity in brain neurons that can cause changes in behavior, mood, movements, and level of consciousness. If patients have two or more unprovoked seizures, they are diagnosed as having epilepsy.

When pathways of communication between neurons (nerve cells) in the brain are disrupted, the opportunity for seizures arises. A common cause for seizures is epilepsy, although seizures can be caused by a variety of triggers:

• High fever, which can be associated with an infection
• Sleep deprivation
• Flashing lights
• Blood in the brain
• Electrolyte disturbances, such as low blood sodium
• Brain damage from prior head trauma, a stroke, or a brain tumor
• Alcohol/drug intoxication or withdrawal
• Medications that lower the seizure threshold, such as certain pain relievers, antidepressants, or smoking cessation therapies (such as bupropion)

Certain triggers, specifically sleep deprivation and flashing lights, can be used in activation procedures for electroencephalogram (EEG) tests, which track and record the brain's electrical activity for any abnormalities. Photic (light) stimulation is often used in standard tests.

About three million people in the United States are diagnosed with epilepsy. Epileptic seizures occur when abnormal, excessive synchronous electrical activity occurs in the surface of the brain called the cortex.

Some symptoms of an epileptic seizure include contraction or jerking of muscles, loss of consciousness, weakness, anxiety, and staring. Some people with epilepsy notice that changes in the weather, exposure to certain smells, and even stress can act as a trigger for seizures.

In some cases, an episode of epileptic seizures is accompanied by an aura. Auras are distinct perceptions felt around the time a seizure occurs. These perceptions can be auditory (hearing), olfactory (smell), visual, somatosensory, gustatory (taste), abdominal (similar to feeling nausea), motor, autonomic (shivers or goosebumps), and psychic.

There are several different kinds of seizures, but the most common type in epilepsy are focal seizures. Focal seizures involve only one area or one side of the brain. They are characterized by two types:

The presence of epileptic seizures is confirmed by an analysis of EEG recordings, the patient’s medical history, physical observations, and sometimes video monitoring.

Pseudo-seizures, also known as psychogenic non-epileptic spells (PNES), are events that mimic epileptic seizures but are not associated with abnormal brain electrical activity which characterizes epileptic seizures. PNES and epileptic seizures sometimes have similar features like convulsions and alterations in behavior and consciousness.

PNES have a psychological origin and the condition is commonly found among those dealing with depression, post-traumatic stress disorder (PTSD), and personality disorders. History of sexual or physical abuse are also risk factors for the development of PNES.

Most patients dealing with PNES tend to be adult women. Additionally, individuals who have family members with epilepsy have a higher chance of developing PNES.

The rate of PNES is highly debated. It is estimated that 2–33 per 100,000 people in the United States have PNES. It is also suggested that 10 to 20 percent of the three million Americans diagnosed with epilepsy actually have PNES. About 20 to 50 percent of those admitted in seizure monitoring units for extended EEGs have PNES rather than epilepsy.

Pseudo-seizures are not easily detected by observation alone and often require an EEG and video monitoring in order to come to a final diagnosis.

Patients with PNES may have abnormalities, or lesions, that appear on structural brain images, but these are not associated with seizures. PNES events typically occur when the individual is awake, are often longer than epileptic seizures, and may end abruptly.

Certain movements are also more commonly seen in PNES than in epileptic seizures, such as thrashing and pelvic thrusting. Furthermore, the absence of motor features during a seizure and prolonged body limpness are features more often seen in cases of PNES rather than cases of epilepsy.

Video-EEG monitoring is the standard diagnostic procedure for PNES. This can record any clinical findings as well as the brain's electrical activity. For proper differentiation, a typical episode should be recorded, verified by the patient or family, and evaluated.

Treatment of PNES might be difficult, and it is established that antiepileptic drugs (AEDs) are not of any benefit. Psychological treatment and alternative medications, including antidepressants, might be beneficial in treating PNES.

While the evidence for stress as a cause of seizures is inconsistent, stress is a common factor in those with pseudo-seizures.

Stress is not always a bad thing. Optimal or eustress can promote adaptation and growth. However, stress that is overwhelming or chronic can lead to a variety of problems.

A stress response, familiarly known as “fight or flight,” is appropriate in moments of urgency. Prolonging a stress response can take a toll on the body physically and emotionally.

Feeling stressed can cause a variety of physical responses, such as an upset stomach, chest pain, elevated blood pressure, headaches, sexual dysfunction, and problems sleeping. Emotional problems like depression, panic attacks, lack of motivation, and various forms of anxiety can arise.

Prolonged and chronic stress wears down the body's natural defense mechanisms and increases the risk of several health problems including:

Whether you are diagnosed with seizures or PNES, seizures or seizure-like episodes can be associated with stress. Managing stress is an important tool, used in combination with any treatment prescribed by your doctor.

Learning to identify stressors and taking care of yourself physically and emotionally in stressful periods is a key part of reducing stress.

If you are dealing with anxiety and depression, your provider may also suggest anxiolytic (anti-anxiety) medication or antidepressants.

Stress is a normal part of life, yet it impacts us physically, emotionally, mentally, and behaviorally. Stress can be associated with seizures, although it is more commonly associated with pseudo-seizures. If you are dealing with episodes of seizures or pseudo-seizures, understanding your stressors and managing stress can help in treating your condition.

If you are dealing with stress and symptoms of seizures, schedule a visit with your doctor or a board-certified neurologist to find out about the diagnosis and a treatment plan best suited to your needs.