Stressors at the onset of adult epilepsy: implications for practice

The association between major life events and seizure frequency in patients with chronic epilepsy has previously been suggested in the literature. However, significant life events as precipitating factors for the occurrence of the first seizure have been considered but not documented. Recognition of such triggers may lead to a better understanding of the cause and mechanism of the epilepsy. Using a phenomenological approach, 19 participants were interviewed and recalled the occurrence of significant life events in the year prior to a diagnosis of generalized or focal epilepsy. There were gender and age-related differences in the types of triggering events, e.g. men tended to specify work related stressors while women generally cited relationship issues. None of the participants reported constraining beliefs about the cause of their epilepsy. Most respondents incorporated their knowledge of seizure triggers into strategies to achieve control of their epilepsy. This study highlights the potential value of questioning possible life stressors as triggers for the onset of epilepsy. Early awareness of high risk factors for seizures may lead to strategies of seizure self control by avoiding situations associated with high risks, improving lives disrupted by the uncertainty of epilepsy.