Wikipedia

Causes of seizures

(Redirected fromSeizure trigger)

Generally, seizures are observed in patients who do not have epilepsy.[1]There are manycauses of seizures.Organ failure, medication and medication withdrawal, cancer, imbalance of electrolytes,hypertensive encephalopathy,may be some of its potential causes.[2]The factors that lead to aseizureare often complex and it may not be possible to determine what causes a particular seizure, what causes it to happen at a particular time, or how often seizures occur.[3]

Diet

edit

Malnutritionandovernutritionmay increase the risk of seizures.[4]Examples include the following:

Folic acidin large amounts was considered to potentially counteract the antiseizure effects ofantiepileptic drugsand increase the seizure frequency in some children, although that concern is no longer held by epileptologists.[13]

Medical conditions

edit
Brain tumors are among many medical conditions in which seizures can be a symptom

Those with various medical conditions may experience seizures as one of their symptoms. These include:[citation needed]

Other conditions have been associated with lower seizure thresholds and/or increased likelihood of seizure comorbidity (but not necessarily with seizure induction). Examples includedepression,psychosis,obsessive-compulsive disorder(OCD),attention deficit hyperactivity disorder(ADHD), andautism,among many others.

Drugs

edit

Adverse effect

edit

Seizures may occur as anadverse effectof certain drugs. These include:[medical citation needed]

Use of certainrecreational drugsmay lead to seizures in some, especially when used in high doses or for extended periods. These includeamphetamines(such asamphetamine,methamphetamine,MDMA( "ecstasy" ), andmephedrone),cocaine,methylphenidate,psilocybin,psilocin,andGHB.

If treated with the wrong kind of antiepileptic drugs (AED), seizures may increase, as most AEDs are developed to treat a particular type of seizure.

Convulsantdrugs (the functional opposites of anticonvulsants) will always induce seizures at sufficient doses. Examples of such agents — some of which are used or have been used clinically and others of which are naturally occurring toxins — includestrychnine,bemegride,flumazenil,cyclothiazide,flurothyl,pentylenetetrazol,bicuculline,cicutoxin,andpicrotoxin.

Alcohol

edit

There are varying opinions on the likelihood ofalcoholic beveragestriggering a seizure. Consuming alcohol may temporarily reduce the likelihood of a seizure immediately following consumption. But, after theblood alcohol contenthas dropped, chances may increase. This may occur, even in non-epileptics.[15]

Heavy drinking in particular has been shown to possibly have some effect on seizures in epileptics. But studies have not found light drinking to increase the likelihood of having a seizure at all.[citation needed]EEGstaken of patients immediately following light alcohol consumption have not revealed any increase in seizure activity.[16]

Consuming alcohol with food is less likely to trigger a seizure than consuming it without.[17]

Consuming alcohol while using many anticonvulsants may reduce the likelihood of the medication working properly. In some cases, it may trigger a seizure. Depending on the medication, the effects vary.[18]

Drug withdrawal

edit

Somemedicinalandrecreationaldrugs can dose-dependently precipitate seizures in withdrawal, especially when withdrawing from high doses and/or chronic use. Examples include drugs that affectGABAergicand/orglutamatergicsystems, such asalcohol(seealcohol withdrawal),[19]benzodiazepines,barbiturates,andanesthetics,among others.

Sudden withdrawal fromanticonvulsantsmay lead to seizures. It is for this reason that if a patient's medication is changed, the patient will be weaned from the medication being discontinued following the start of a new medication.

Missed anticonvulsants

edit

Amissed doseor incorrectly timed dose of an anticonvulsant may be responsible for a breakthrough seizure, even if the person often missed doses in the past, and has not had a seizure as a result.[20]Missed doses are one of the most common reasons for abreakthrough seizure.A single missed dose is capable of triggering a seizure in some patients.[21]

  • Incorrect dosage amount: A patient may be receiving a sub-therapeutic level of the anticonvulsant.[22]
  • Switching medicines: This may include withdrawal of anticonvulsant medication without replacement, replaced with a less effective medication, or changed too rapidly to another anticonvulsant. In some cases, switching from brand to agenericversion of the same medicine may induce a breakthrough seizure.[23][24]

Fever

edit

In children between the ages of 6 months and 5 years, afeverof 38 °C (100.4 °F) or higher may lead to afebrile seizure.[25]About 2-5% of all children will experience such a seizure during their childhood.[26]In most cases, a febrile seizure will not indicate epilepsy.[26]Approximately 40% of children who experience a febrile seizure will have another one.[26]

In those with epilepsy, fever can trigger a seizure. Additionally, in some,gastroenteritis,which causesvomitinganddiarrhea,can lead to diminished absorption of anticonvulsants, thereby reducing protection against seizures.[27]

Vision

edit
Main article:Photosensitive epilepsy
Flashing light, such as that from adisco ball,can cause seizures in some people

In some epileptics, flickering or flashing lights, such asstrobe lights,can be responsible for the onset of atonic clonic,absence,ormyoclonicseizure.[28]This condition is known asphotosensitive epilepsyand, in some cases, the seizures can be triggered by activities that are harmless to others, such as watching television or playing video games, or by driving or riding during daylight along a road with spaced trees, thereby simulating the "flashing light" effect. Some people can have a seizure as a result of blinking one's own eyes.[29]Contrary to popular belief, this form of epilepsy is relatively uncommon, accounting for just 3% of all cases.[30]

A routine part of theEEGtest involves exposing the patient to flickering lights to attempt to induce a seizure, to determine if such lights may be triggering a seizure in the patient, and to be able to read the wavelengths when such a seizure occurs.[29]

In photosensitive epilepsies, epileptic activity only appears for few seconds after eye-closure. In some non-photosensitive epilepsies, seizures may be triggered by the loss ofcentral visionduring eye-closure, in an phenomenon calledfixation-off sensitivity(FOS), where the epileptic activity persists for the total duration of eye-closure. Though unrelated phenomena, photosensitive and non-photosensitive epilepsies can occur together in some patients.[31][32][33]

Head injury

edit

A severehead injury,such as one sustained in amotor vehicle accident,fall,assault,orsports injury,can result in one or more seizures that can occur immediately after the fact or up to a significant amount of time later.[34]This could be hours, days, or even years following the injury.

A brain injury can cause seizure(s) because of the unusual amount of energy that is discharged across of the brain when the injury occurs and thereafter. A disruption of the supply ofoxygenmay cause damage to thetemporal lobeof the brain.[35]

The risk of seizure(s) from aclosed head injuryis about 15%.[36]In some cases, a patient who has had a head injury is given anticonvulsants, even if no seizures have occurred, as a precaution to prevent them in the future.[37]

Hyperglycemia and hypoglycemia

edit

Hyperglycemia,or high blood sugar, can increase frequency of seizure. The probable mechanism is that elevated extracellular glucose level increases neuronal excitability.[38]

Curiously,hypoglycemia,or low blood sugar, can also trigger seizures.[39]The mechanism is also increased cortical excitability.[40]

Menstrual cycle

edit

Incatamenial epilepsy,seizures become more common during a specific period of themenstrual cycle.

Sleep deprivation

edit

Sleep deprivationis the second most common trigger of seizures.[15]In some cases, it has been responsible for the only seizure a person ever has.[41]However, the reason for which sleep deprivation can trigger a seizure is unknown. One possible thought is that the amount of sleep one gets affects the amount of electrical activity in one's brain.[42]

Patients who are scheduled for an EEG test are asked to deprive themselves of some sleep the night before to be able to determine if sleep deprivation may be responsible for seizures.[43]

In some cases, patients with epilepsy are advised to sleep 6-7 consecutive hours as opposed to broken-up sleep (e.g., 6 hours at night and a 2-hour nap) and to avoidcaffeineandsleeping pillsin order to prevent seizures.[44]

Parasites and stings

edit

In some cases, certainparasitescan cause seizures. TheSchistosomasp. flukes causeSchistosomiasis.Pork tapewormandbeef tapewormcause seizures when the parasite createscystsat the brain.Echinococcosis,malaria,toxoplasmosis,African trypanosomiasis,and many other parasitic diseases can cause seizures.

Seizures have been associated with insect stings. Reports suggest that patients stung byred imported fire ants(Solenopsis invicta) andPolisteswasps had seizures because of the venom.[45][46]

In endemic areas,neurocysticercosisis the main cause behindfocal epilepsyin early adulthood. All growth phases ofcysticerci(viable, transitional and calcified) are associated with epileptic seizures. Thus, anti-cysticercus treatment helps by getting rid of it thus lowers the risk of recurrence of seizures in patients with viable cysts.Symptomatic epilepsycan be the first manifestation ofneuroschistosomiasisin patients without any systemic symptoms. The pseudotumoral form can trigger seizures secondary to the presence ofgranulomasandoedemasin the cerebral cortex.[47]

Stress

edit

Stress can induce seizures in people withepilepsy,and is a risk factor for developing epilepsy. Severity, duration, and time at which stress occurs during development all contribute to frequency and susceptibility to developing epilepsy. It is one of the most frequently self-reported triggers in patients with epilepsy.[48][49]

Stress exposure results inhormonerelease that mediates its effects in the brain. These hormones act on both excitatory and inhibitory neuralsynapses,resulting in hyper-excitability ofneuronsin the brain. Thehippocampusis known to be a region that is highly sensitive to stress and prone toseizures.This is where mediators of stress interact with their target receptors to produce effects.[50]

"Epileptic fits" as a result of stress are common in literature and frequently appear in Elizabethan texts, where they are referred to as the "falling sickness".[51]

Breakthrough seizure

edit

A breakthrough seizure is anepileptic seizurethat occurs despite the use ofanticonvulsantsthat have otherwise successfully prevented seizures in the patient.[52]: 456 Breakthrough seizures may be more dangerous than non-breakthrough seizures because they are unexpected by the patient, who may have considered themselves free from seizures and, therefore, not take any precautions.[53]Breakthrough seizures are more likely with a number of triggers.[54]: 57 Often when a breakthrough seizure occurs in a person whose seizures have always been well controlled, there is a new underlying cause to the seizure.[55]

Breakthrough seizures vary. Studies have shown the rates of breakthrough seizures ranging from 11 to 37%.[56]Treatment involves measuring the level of the anticonvulsant in the patient's system and may include increasing the dosage of the existing medication, adding another medication to the existing one, or altogether switching medications.[57]A person with a breakthrough seizure may require hospitalization for observation.[52]: 498 

Other

edit

Music (as inmusicogenic epilepsy)[59][60][61]

Diagnosis and management

edit

In the case of patients with seizures associated with medical illness, the patients are firstly stabilized. They are attended to their circulation, airway, and breathing. Next vital signs are assessed through a monitor, intravenous access is obtained, and concerning laboratory tests are performed.Phenytoinorfosphenytoinsupplemented withbenzodiazepinesare administered as the first line of therapy if the seizure persists for more than 5 –10 minutes. Through neuroimaging, clinical assessments, and spinal-fluid examination the patients are screened for intrinsic neurological anomalies. The patients are analyzed fornon-epileptic seizures.Earlyelectroencephalographyis recommended if there is a possibility of non-convulsive or subtle status epilepticus. They are examined for disorders such assarcoidosis,porphyria,and other unusual systemic disorders. Information is gathered on the drug, medication history, and its withdrawal. For seizures associated with alcohol,intravenouspyridoxineand other specificantidotesare prescribed. The patient is checked forproconvulsantexposure. All underlying potential causes are considered. For instance, in a patient with an end-stage renal disease where there is a probability ofhypertensive encephalopathy,blood pressure is analyzed.[2]

References

edit
  1. ^Delanty, Norman; Vaughan, Carl J.; French, Jacqueline A. (1998-08-01)."Medical causes of seizures".The Lancet.352(9125): 383–390.doi:10.1016/S0140-6736(98)02158-8.ISSN0140-6736.PMID9717943.S2CID42324759.
  2. ^abDelanty, Norman; Vaughan, Carl J; French, Jacqueline A (1998-08-01)."Medical causes of seizures".The Lancet.352(9125): 383–390.doi:10.1016/S0140-6736(98)02158-8.ISSN0140-6736.PMID9717943.S2CID42324759.
  3. ^"Epilepsy Foundation".
  4. ^Jonathan H. Pincus; Gary J. Tucker (27 September 2002).Behavioral Neurology.Oxford University Press. p. 4.ISBN978-0-19-803152-9.
  5. ^100 Questions & Answers About Epilepsy, Anuradha Singh, page 79
  6. ^Keyser, A.; De Bruijn, S.F.T.M. (1991). "Epileptic Manifestations and Vitamin B1Deficiency ".European Neurology.31(3): 121–5.doi:10.1159/000116660.PMID2044623.
  7. ^Fattal-Valevski, A.; Bloch-Mimouni, A.; Kivity, S.; Heyman, E.; Brezner, A.; Strausberg, R.; Inbar, D.; Kramer, U.; Goldberg-Stern, H. (2009). "Epilepsy in children with infantile thiamine deficiency".Neurology.73(11): 828–33.doi:10.1212/WNL.0b013e3181b121f5.PMID19571254.S2CID16976274.
  8. ^Vitamin B-6 Dependency SyndromesateMedicine
  9. ^Matsumoto, Arifumi; Shiga, Yusei; Shimizu, Hiroshi; Kimura, Itaru; Hisanaga, Kinya (2009)."Encephalomyelopathy due to vitamin B12 deficiency with seizures as a predominant symptom".Rinsho Shinkeigaku.49(4): 179–85.doi:10.5692/clinicalneurol.49.179.PMID19462816.
  10. ^Kumar, S (2004)."Recurrent seizures: an unusual manifestation of vitamin B12 deficiency".Neurology India.52(1): 122–3.PMID15069260.
  11. ^Mustafa TAŞKESEN; Ahmet YARAMIŞ; Selahattin KATAR; Ayfer GÖZÜ PİRİNÇÇİOĞLU; Murat SÖKER (2011)."Neurological presentations of nutritional vitamin B12 deficiency in 42 breastfed infants in Southeast Turkey"(PDF).Turk J Med Sci.41(6). TÜBİTAK: 1091–1096. Archived fromthe original(PDF)on 2013-12-14.Retrieved2014-10-01.
  12. ^Yavuz, Halûk (2008). "Vitamin B12 deficiency and seizures".Developmental Medicine and Child Neurology.50(9): 720.doi:10.1111/j.1469-8749.2008.03083.x.PMID18754925.S2CID9565203.
  13. ^Morrell, Martha J. (2002)."Folic Acid and Epilepsy".Epilepsy Currents.2(2): 31–34.doi:10.1046/j.1535-7597.2002.00017.x.PMC320966.PMID15309159.
  14. ^Devinsky, Orrin; Schachter, Steven; Pacia, Steven (2005).Complementary and Alternative Therapies for Epilepsy.New York, N.Y.: Demos Medical Pub.ISBN9781888799897.
  15. ^abEngel, Jerome; Pedley, Timothy A.; Aicardi, Jean (2008).Epilepsy: A Comprehensive Textbook.Lippincott Williams & Wilkins. pp. 78–.ISBN978-0-7817-5777-5.
  16. ^Wilner, Andrew N. (1 November 2000).Epilepsy in Clinical Practice: A Case Study Approach.Demos Medical Publishing. pp. 92–.ISBN978-1-888799-34-7.
  17. ^"Epilepsy Foundation".
  18. ^Wilner, Andrew N. (1 November 2000).Epilepsy in Clinical Practice: A Case Study Approach.Demos Medical Publishing. pp. 93–.ISBN978-1-888799-34-7.
  19. ^Orrin Devinsky (1 January 2008).Epilepsy: Patient and Family Guide.Demos Medical Publishing, LLC. p. 63.ISBN978-1-934559-91-8.
  20. ^Orrin Devinsky (1 January 2008).Epilepsy: Patient and Family Guide.Demos Medical Publishing, LLC. p. 120.ISBN978-1-934559-91-8.
  21. ^Steven S. Agabegi; Elizabeth D. Agabegi (2008).Step-up to medicine.Lippincott Williams & Wilkins. p.230.ISBN978-0-7817-7153-5.missed doseseizure.
  22. ^Crain, Ellen F.; Gershel, Jeffrey C. (2003).Clinical manual of emergency pediatrics(4th ed.). New York: McGraw-Hill, Medical Publishing Division.ISBN9780071377508.
  23. ^Singh, Anuradha (2009).100 Questions & Answers About Your Child's Epilepsy.Sudbury, Massachusetts: Jones and Bartlett. p.120.ISBN9780763755218.
  24. ^MacDonald, J. T. (December 1987). "Breakthrough seizure following substitution of Depakene capsules (Abbott) with a generic product".Neurology.37(12): 1885.doi:10.1212/wnl.37.12.1885.PMID3120036.S2CID44324824.
  25. ^Greenberg, David A.; Michael J. Aminoff; Roger P. Simon (2012). "12".Clinical neurology(8th ed.). New York: McGraw-Hill Medical.ISBN978-0071759052.
  26. ^abcGraves, RC; Oehler, K; Tingle, LE (Jan 15, 2012). "Febrile seizures: risks, evaluation, and prognosis".American Family Physician.85(2): 149–53.PMID22335215.
  27. ^Orrin Devinsky (1 January 2008).Epilepsy: Patient and Family Guide.Demos Medical Publishing, LLC. p. 67.ISBN978-1-934559-91-8.
  28. ^Thomas R. Browne; Gregory L. Holmes (2008).Handbook of Epilepsy.Jones & Bartlett Learning. p. 129.ISBN978-0-7817-7397-3.
  29. ^abGraham F A Harding; Peter M Jeavons (10 January 1994).Photosensitive Epilepsy.Cambridge University Press. p. 16.ISBN978-1-898683-02-5.
  30. ^"Flickering light and seizurs".Pediatrics for Parents.March 2005. Archived fromthe originalon 2012-07-09 – viaFindArticles.
  31. ^Seneviratne, Udaya; Cook, Mark J. & D'Souza, Wendyl Jude (2017)."Electroencephalography in the Diagnosis of Genetic Generalized Epilepsy Syndromes".Frontiers in Neurology.8:499.doi:10.3389/fneur.2017.00499.PMC5622315.PMID28993753.RetrievedNovember 19,2022.
  32. ^Nagele, Eric P.; Gutierrez, Camilo A.; Achieng, Elsie; Hopp, Jennifer L. (August 11, 2020)."Fixation-off sensitivity in focal epilepsy due to posterior quadrantic dysplasia"(PDF).Neurology.95(13): 597–598.doi:10.1212/WNL.0000000000010621.PMID32788240.S2CID221125236.RetrievedNovember 19,2022.
  33. ^Wallace, Sheila J.; Farrell, Kevin (2004).Epilepsy in Children, 2E.CRC Press. p. 246.ISBN9780340808146.
  34. ^Overview of Head Injuries: Head InjuriesMerck Manual Home Edition
  35. ^Diane Roberts Stoler (1998).Coping with Mild Traumatic Brain Injury.Penguin. p. 124.ISBN978-0-89529-791-4.
  36. ^Donald W. Marion (1999).Traumatic Brain Injury.Thieme. p. 107.ISBN978-0-86577-727-9.
  37. ^"Head Injury as a Cause of Epilepsy".EpilepsyFoundation.org.Archived fromthe originalon 2011-06-23.Retrieved2011-06-23.Epilepsy Foundation
  38. ^Stafstrom, Carl E. (July 2003)."Hyperglycemia Lowers Seizure Threshold".Epilepsy Currents.3(4): 148–149.doi:10.1046/j.1535-7597.2003.03415.x.ISSN1535-7597.PMC387262.PMID15309063.
  39. ^Varghese, Precil; Gleason, Vanessa; Sorokin, Rachel; Senholzi, Craig; Jabbour, Serge; Gottlieb, Jonathan E. (2007)."Hypoglycemia in hospitalized patients treated with antihyperglycemic agents".Journal of Hospital Medicine.2(4): 234–240.doi:10.1002/jhm.212.ISSN1553-5592.PMID17702035.
  40. ^Falip, Mercè; Miró, Júlia; Carreño, Mar; Jaraba, Sònia; Becerra, Juan Luís; Cayuela, Núria; Perez Maraver, Manuel; Graus, Francesc (2014-11-15)."Hypoglycemic seizures and epilepsy in type I diabetes mellitus".Journal of the Neurological Sciences.346(1): 307–309.doi:10.1016/j.jns.2014.08.024.ISSN0022-510X.PMID25183236.S2CID7207035.
  41. ^"Can sleep deprivation trigger a seizure?".epilepsy.com.Archived fromthe originalon 2013-10-29.Retrieved2013-10-29.
  42. ^Orrin Devinsky (1 January 2008).Epilepsy: Patient and Family Guide.Demos Medical Publishing, LLC. p. 61.ISBN978-1-934559-91-8.
  43. ^Ilo E. Leppik, MD (24 October 2006).Epilepsy: A Guide to Balancing Your Life.Demos Medical Publishing. p. 136.ISBN978-1-932603-20-0.
  44. ^Orrin Devinsky (1 January 2008).Epilepsy: Patient and Family Guide.Demos Medical Publishing, LLC. p. 62.ISBN978-1-934559-91-8.
  45. ^Candiotti, Keith A.; Lamas, Ana M. (1993). "Adverse neurologic reactions to the sting of the imported fire ant".International Archives of Allergy and Immunology.102(4): 417–420.doi:10.1159/000236592.PMID8241804.
  46. ^Gonzalo Garijo, M.A.; Bobadilla González, P.; Puyana Ruiz, J. (1995). "Epileptic attacks associated with wasp sting-induced anaphylaxis".Journal of Investigational Allergology & Clinical Immunology.6(4): 277–279.PMID8844507.
  47. ^Moyano, Luz M.; Saito, Mayuko; Montano, Silvia M.; Gonzalvez, Guillermo; Olaya, Sandra; Ayvar, Viterbo; González, Isidro; Larrauri, Luis; Tsang, Victor C. W.; Llanos, Fernando; Rodríguez, Silvia (2014-02-13)."Neurocysticercosis as a Cause of Epilepsy and Seizures in Two Community-Based Studies in a Cysticercosis-Endemic Region in Peru".PLOS Neglected Tropical Diseases.8(2): e2692.doi:10.1371/journal.pntd.0002692.ISSN1935-2727.PMC3923674.PMID24551255.
  48. ^Nakken, Karl O.; Solaas, Marit H.; Kjeldsen, Marianne J.; Friis, Mogens L.; Pellock, John M.; Corey, Linda A. (2005). "Which seizure-precipitating factors do patients with epilepsy most frequently report?".Epilepsy & Behavior.6(1): 85–89.doi:10.1016/j.yebeh.2004.11.003.PMID15652738.S2CID36696690.
  49. ^Haut, Sheryl R.; Hall, Charles B.; Masur, Jonathan; Lipton, Richard B. (2007-11-13). "Seizure occurrence: precipitants and prediction".Neurology.69(20): 1905–1910.doi:10.1212/01.wnl.0000278112.48285.84.ISSN1526-632X.PMID17998482.S2CID27433395.
  50. ^Gunn, B.G.; Baram, T.Z. (2017)."Stress and Seizures: Space, Time and Hippocampal Circuits".Trends in Neurosciences.40(11): 667–679.doi:10.1016/j.tins.2017.08.004.PMC5660662.PMID28916130.
  51. ^Jones, Jeffrey M. (2000)."'The Falling Sickness' in Literature ".Southern Medical Journal.93(12): 1169–72.doi:10.1097/00007611-200012000-00006.PMID11142451.S2CID31281356.
  52. ^abAmerican Academy of Orthopaedic Surgeons (2006).Emergency care and transportation of the sick and injured(9th ed.). Sudbury, Massachusetts: Jones and Bartlett. pp. 456, 498.ISBN9780763744052.
  53. ^Ettinger, Alan B.; Adiga, Radhika K. (2008)."Breakthrough Seizures—Approach to Prevention and Diagnosis".US Neurology.4(1): 40–42.doi:10.17925/USN.2008.04.01.40.
  54. ^abcDevinsky, Orrin (2008).Epilepsy: Patient and Family Guide(3rd ed.). New York: Demos Medical Publishing. pp. 57–68.ISBN9781932603415.
  55. ^Lynn, D. Joanne; Newton, Herbert B.; Rae-Grant, Alexander D. (2004).The 5-Minute Neurology Consult.LWW medical book collection. Philadelphia: Lippincott Williams & Wilkins. p. 191.ISBN9780683307238.
  56. ^Pellock, John M.; Bourgeois, Blaise F.D.; Dodson, W. Edwin; Nordli Jr., Douglas R.; Sankar, Raman (2008).Pediatric Epilepsy: Diagnosis and Therapy.Springer Demos Medicical Series (3rd ed.). New York: Demos Medical Publishing. p. 287.ISBN9781933864167.
  57. ^Engel Jr., Jerome; Pedley, Timothy A.; Aicardi, Jean (2008).Epilepsy: A Comprehensive Textbook(2nd ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.ISBN9780781757775.
  58. ^Freeman, John M.; Kossoff, Eric; Kelly, Millicent (2006).Ketogenic Diets: Treatments for Epilepsy.Demos Health Series (4th ed.). New York: Demos. p. 54.ISBN9781932603187.
  59. ^Stern, John (2015). "Musicogenic epilepsy".The Human Auditory System - Fundamental Organization and Clinical Disorders.Handbook of Clinical Neurology. Vol. 129. pp. 469–477.doi:10.1016/B978-0-444-62630-1.00026-3.ISBN9780444626301.ISSN0072-9752.PMID25726285.
  60. ^"music and epilepsy".Epilepsy Society.2015-08-10.Retrieved2017-09-16.
  61. ^Maguire, Melissa Jane (21 May 2012)."Music and epilepsy: a critical review".Epilepsia.53(6): 947–61.doi:10.1111/j.1528-1167.2012.03523.x.PMID22612325.S2CID33600372.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Causes_of_seizures&oldid=1224549775"