Seizure precipitants and inhibiting factors in mesial temporal lobe epilepsy

Epileptic seizures may be triggered by both nonspecific facilitating factors and specific reflex epileptic mechanisms. These consist of sensory or cognitive inputs activating neural networks that, due to some functional instability, may respond with an epileptic discharge. The aim of this study was to determine the prevalence and nature of self-perceived seizure-inducing and -inhibiting factors in patients with mesial temporal lobe epilepsy (MTLE) followed from March 3rd to December 8th, 2009 at the Centro de Epilepsia de Santa Catarina Outpatient Clinic of the Hospital Governador Celso Ramos in Florianópolis, Brazil and their relation to demographics, epilepsy-related variables and anxiety level. Of the 71 patients, 60 (84.5%) patients identified at least one seizure trigger, and 36 (50.7%) patients identified inhibiting factors. In order of frequency, the most freely recalled precipitants were nervousness (58.8%), worrying (21.6%) and menstruation (19.6%), while the precipitants that were most frequently identified from a list were worrying (73.2%), anxiety (66.2%) and anger (53.5%). Knowledge of precipitant factors may have implications on the treatment and seizure control of patients.