Mind & Body

Epileptic Seizures Can Be Triggered by a Lot More Than Just Lights

Even to medical professionals, epilepsy is a bit of a mystery. The brain is incredibly complicated even when it's working properly, so if something misfires or gets overloaded, it can get a lot more complicated, frighteningly fast. You're probably aware that many epileptic seizures are caused by bright, rapidly flashing lights, but there are a lot of other potential triggers that could pose a threat.

Mysteries of the Mind

About half of the people with an epilepsy diagnosis have no identifiable cause for their condition. Even for those who can point to a particular reason, the actual mechanism of the disorder is poorly understood. Basically, the causes can range from genetics to injury to diseases and disorders, with strokes, concussions, and infections such as meningitis being some of the most likely culprits.

Besides having murky origins, epileptic seizures can also look a lot different than the average person might expect. The stereotypical seizure, characterized by loss of consciousness and uncontrollable shaking and stiffening, is known as a tonic-clonic seizure (previously called a "grand mal seizure") and is only one of many different varieties. It's a type of generalized onset seizure, one of three distinct seizure types that are categorized by where they start in the brain. Generalized onset seizures start in both sides of the brain simultaneously. The other main example of this type is called an absence seizure — characterized by staring blankly, losing awareness of your surroundings, and lasting only a couple of seconds.

Unlike generalized onset seizures, focal onset seizures start in just one cluster of brain cells. They can present in a lot of different ways — during a focal onset aware seizure, a person might experience symptoms like hallucinations, nausea, migraine, or even déjà vu. As the name implies, the person is awake and aware while it happens and will remember what they experienced. By contrast, a focal onset impaired awareness seizure causes the person to lose awareness of their surroundings — they may pick at their clothes, repeat certain words or phrases, and even start to wander, but they won't have any memory of their experience afterward.

There's one last type of seizure, but it's sort of a catch-all. If medical professionals can't identify where the seizure started, then they call it an unknown onset seizure. A seizure that starts in one area of the brain can spread to others, making it more complicated to diagnose. But the different causes of epilepsy and the different types of seizures are only two of the ways the disorder can take many different forms. There are also the different types of triggers — and this is where public perception differs greatly from real-world experience.

Trigger-Happy Tremors

In one high-profile incident, a 1997 episode of Pokémon caused panic all across Japan when children began having seizures triggered by strobing red and blue lights. Even after being edited to remove the harmful effect, the episode was never aired again in any country — and likely cemented flashing lights in the public consciousness as the major trigger for epileptic seizures. However, there are a lot of other ways that a seizure in the brain can start. Brains are complex machines that perform complex actions, so it's sometimes surprising how certain patterns start to express themselves.

In 1993, a group of doctors wrote into the Journal of Neurology to tell the fascinating story of the aptly named "Mr. Pinocchio," who had recently begun to experience seizures brought on by dishonesty. That's right: Every time Mr. Pinocchio told a lie, his ruse would be revealed by an uncontrollable seizure. As it turned out, he had developed a brain tumor that, once removed, ceased to have this effect on him.

The doctors decided that what was happening to Mr. Pinocchio was essentially a strong emotional reaction — telling a lie elicited a certain response that happened to interact with his tumor in an unexpected way. Another way brain activity can start something dangerous? Trying to do math in your head: A patient in a 1982 report experienced seizures when doing multiplication, division, and spatial manipulation, but not addition or subtraction. Listening to certain pieces of music can also trigger what are called musicogenic seizures. In one case, a woman reported experiencing seizures when exposed to singing, flute music, or electronic or heavy metal music. Madonna was the worst offender.

On that subject, though, music can also have a healing property. They call it "the Mozart effect" (not to be confused with the myth about Mozart making babies smarter). Specifically, listening to the Sonata for Two Pianos in D for 10 to 15 minutes has been found to help relieve some key symptoms in children and adults with epilepsy, including reducing the number of seizures they experienced. There's still not a clear reason why this should be, however — but for now, perhaps that isn't as important as the relief the music can provide.

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There are more than 7 billion ways a human brain can work. To discover what else your neurology might be hiding, take a deep dive with Oliver Sacks in "The River of Consciousness" (it's free with your trial membership to Audible). We handpick reading recommendations we think you may like. If you choose to make a purchase through that link, Curiosity will get a share of the sale.

Written by Reuben Westmaas July 27, 2018

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