title: Seizure precipitants (triggering factors) in patients with epilepsy.
abstract: OBJECTIVE
  adult epilepsy clinic population: (a) to identify the frequency of seizure precipitants (triggering factors) and their relative frequency in those with psychiatric disorders, and in those in remission or with active epilepsy, differences in frequency with regard to gender, seizure duration, number of drugs taken; (b) to determine which precipitants patients most commonly report; and (c) to identify differences in the distribution of precipitants among generalized, temporal, and extratemporal epilepsies.
  
  
  METHODS
  Consecutive patients attending a tertiary-care epilepsy clinic were prospectively and an open personal interview to identify and characterize seizure precipitants. Information about the epilepsy and clinical characteristics of patients was collected during the interview and from medical records.
  
  
  RESULTS
  Of 104 patients, 97% cited at least one precipitant. Stress, sleep deprivation, and fatigue were the most frequently reported precipitants. Patients with psychological comorbidities reported a greater percentage of seizures with seizure precipitants. Patients with idiopathic generalized epilepsy seemed to be more sensitive to seizures during awakening and sleep deprivation, patients with extratemporal epilepsy reported more frequent seizures during sleep. There were no differences in frequency or type of seizure precipitants with regard to gender, seizure duration or frequency, and the number of antiepileptic drugs taken.
  
  
  CONCLUSIONS
  The findings may have implications for the better management of epilepsy by increasing a focus on nonpharmacological therapy. The implications of the findings for nosology and causation of epilepsy are also briefly discussed.
authors.affiliation: UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Division of Neurology, University Hospital of Verona, P.le A. Stefani 1, 37126 Verona, Italy. Electronic address: monica.ferlisi@ospedaleuniverona.it.
authors.forename: Monica
authors.initials: M
authors.lastname: Ferlisi
authors.affiliation: UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Shorvon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D012892:Sleep Deprivation / Q000150:complications*; D013315:Stress, Psychological / Q000150:complications*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy; Generalized and partial epilepsies; Seizure precipitants; Sleep deprivation; Stress