The Connection Between Stress and Seizures

Stress has a profound impact on the body from disrupting sleep and digestion to spiking blood pressure but in some cases, it can also trigger seizures or seizure-like events. These episodes may occur in people diagnosed with epilepsy or in those without any history of the condition. Understanding the relationship between stress and seizures is key to managing both your neurological and mental health.

Can Stress Actually Trigger a Seizure?

Yes. Intense or prolonged stress can trigger seizure-like episodes, especially in people with underlying neurological or psychological vulnerabilities. In fact, a specific type of seizure known as a psychogenic non-epileptic seizure (PNES) is directly linked to stress, trauma, or mental health conditions.

PNES outwardly mimics the physical signs of a seizure such as convulsions or unresponsiveness but it is not caused by abnormal electrical activity in the brain, which differentiates it from epilepsy-related seizures.

How Stress Affects the Brain

Stress activates the fight-or-flight response, flooding the body with hormones like cortisol and adrenaline. Over time, elevated stress levels can:

• Alter brain chemistry

• Disrupt emotional regulation

• Overstimulate the nervous system

The emotional processing center of the brain the amygdala communicates with areas like the hypothalamus, which controls physical stress responses. This connection means that emotional stress can lead to very real physical symptoms, including seizures in some individuals.

Understanding Psychogenic Non-Epileptic Seizures (PNES)

PNES are seizures that resemble epilepsy but lack abnormal brain activity. They may be triggered by:

• Anxiety or panic attacks

• Unprocessed trauma

• Depression or mood disorders

• Acute emotional distress

These episodes are often misunderstood or misdiagnosed, especially since they look similar to epileptic seizures. However, a video EEG (vEEG) can help determine the difference by monitoring brain activity during an episode.

Can Anxiety or Panic Attacks Cause Seizures?

Yes, anxiety and panic attacks can lead to seizure-like episodes, especially in people prone to high stress or emotional dysregulation. Hyperventilation during panic attacks can decrease oxygen levels, which may in turn contribute to neurological symptoms or mimic seizure activity.

Interestingly, about 20% of people with epilepsy also experience anxiety, which can make them more vulnerable to both epileptic and stress-induced seizures.

Risk Factors for Stress-Related Seizures

Stress-induced seizures are more likely to occur during times of intense emotional or physical strain, but other contributing factors may include:

• History of trauma or abuse

• Brain injury or concussion

• Anxiety or depression

• Irregular menstrual cycle

• Sleep deprivation

• Nutritional deficiencies

• Personality or mood disorders

• Substance use (alcohol or drugs)

Lack of sleep is especially notable. Studies show that over 50% of people with epilepsy also experience insomnia, and sleep loss is a well-known seizure trigger both for epilepsy and PNES.

Diagnosing Stress-Related Seizures

A neurologist typically performs a combination of:

• Physical exams and medical history

• Blood tests

• Brain imaging (MRI)

• Electroencephalogram (EEG)

A video EEG is often used to distinguish PNES from epileptic seizures. While epileptic seizures show abnormal brain activity, PNES do not. It's important to note that some people may have both types of seizures, which makes accurate diagnosis essential for effective treatment.

How to Prevent Stress-Induced Seizures

Because stress is the root trigger of PNES, daily stress management is key to prevention. Strategies include:

• Mindfulness practices

• Breathing and relaxation exercises

• Cognitive behavioral therapy (CBT)

• Physical activity

• Getting enough sleep

• Seeking emotional support when needed

These techniques can help reduce the intensity and frequency of stress-related episodes. For people with epilepsy, managing stress is equally important, as it can lower the threshold for seizure activity.

When to Seek Medical Help

You should always consult a healthcare provider if:

• You experience a seizure for the first time

• A seizure lasts longer than five minutes

• You don’t regain full consciousness

• Multiple seizures occur in a short period

• Seizures lead to physical injury or trouble breathing

Whether it's a stress-induced episode or a neurological condition like epilepsy, a proper diagnosis ensures you receive the right care plan for your unique situation.

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