Why winter triggers more seizures: Experts explain how to recognise and manage them safely

As India enters peak winter and neurological OPDs report a rise in seizure-related complaints, neurologists are urging families to recognise early warning signs and understand how lifestyle shifts, especially in colder months can quietly raise the risk of episodes.

According to the World Health Organisation (WHO), nearly 50 million people worldwide live with epilepsy and a significant proportion remain untreated due to lack of awareness about how seizures actually present. While most people imagine seizures as dramatic falls and convulsions, experts say many episodes are far more subtle, something that contributes to patients going undiagnosed for years.

Seizures aren’t always dramatic and that’s why they get missed

Dr Shivraj Hunge, Consultant, Neurology at Jupiter Hospital (Pune) said that seizures result from “sudden bursts of abnormal electrical activity in the brain” and can affect awareness, movement, behaviour or even sensations.

Dr Hunge said that seizures broadly fall into two categories focal and generalised, depending on where the abnormal activity begins. “Focal aware seizures may involve “odd smells, unusual feelings or sudden mood shifts while the person remains conscious.” Focal impaired-awareness seizures can cause brief confusion, repetitive behaviours like hand rubbing or lip-smacking and partial loss of awareness. These episodes may last seconds to minutes and can sometimes progress into generalised seizures,” Dr Hunge added.

Generalised seizures, on the other hand, affect both brain hemispheres. Dr Hunge said that generalised seizures are the ones that occur on both sides of the brain at the same time and they are more likely to have more visible symptoms. “The most well known one is tonic-clonic seizure, which is usually initiated by body rigidity and is then proceeded by jerking motions in a rhythmic manner. Air intake might become intermittent and a time of confusion or deep sleep usually succeeds,” he added.

Absence seizures which are common among children manifest themselves as brief spells of staring which last only a few seconds and in which the child fails to respond even though he or she still has open eyes.

Atypical absence seizures are prolonged and can contain such small movements as blinking and slight twitching of the muscles. Other generalised varieties are myoclonic seizures which are characterised by sudden spasmodic contractions of the muscles and atonic seizures, where the muscles loose their tone and this may result in a sudden fall.

Every kind of seizure has its own dangers, including trauma or a long-term disorientation which is why it is necessary to identify it as soon as possible.

Epilepsy vs a single seizure: A major public misconception

Dr Tarun Mathur, Senior Consultant, Neurology at Paras Health (Udaipur) emphasised that not every seizure means epilepsy.

“A single seizure can occur due to fever, infection, high stress or lack of sleep. Epilepsy is diagnosed only when seizures recur without an immediate trigger,” he said, calling the misunderstanding a major driver of stigma.

He adds that many seizures are so subtle that caregivers don’t recognise them: “Episodes of staring, jerks of the arms or legs, unresponsiveness or brief confusion are often overlooked, delaying treatment for years.”

Why winter is a high-risk season for people prone to seizures

Seasonal changes, including shorter daylight hours and colder temperatures, can disrupt sleep cycles—one of the strongest seizure triggers. Dr Mathur said winter brings a cluster of risk factors together:

*Disturbed sleep routines

*Increased screen time

*Higher incidence of flu and infections

*Dehydration from prolonged heater use

*Festive-season stress and irregular meals

“Even short-term lifestyle disruptions during winter, missed meals or inconsistent medication can trigger seizures in vulnerable individuals,” he warned.

“Lifestyle habits matter more than people think. Both neurologists agree that lifestyle management is an essential part of seizure prevention,” he added.

Dr Hunge highlighted sleep hygiene as a “critical factor,” adding that sleep deprivation is among the most common triggers. Stress management, regular exercise, hydration and balanced meals also help regulate brain activity, especially for those prone to metabolic imbalances.

He cautions against “alcohol binges, recreational drug use, and sudden withdrawal from caffeine or sedatives,” which can destabilise the brain’s electrical rhythm.

For those already diagnosed with epilepsy, strict medication adherence is non-negotiable. “Skipping doses can cause breakthrough seizures in people who were stable for months,” Dr Hunge said.

What to do if someone is having a seizure

Dr Mathur outlines simple but critical steps:

*Protect the person from injury

*Turn them on their side

*Remove nearby objects

*Stay with them until recovery

*Do not restrain them

*Do not put anything in their mouth

“Seek emergency care if a seizure lasts longer than five minutes or if the person doesn’t regain awareness,” he said.

“With awareness and support, most people live normal lives Despite widespread myths, both doctors stress that epilepsy is manageable. With timely diagnosis, the right medication, and small but consistent lifestyle choices, particularly during high-risk seasons, people with epilepsy can work, study and live independently.”

“Societal acceptance and understanding play as big a role as medical treatment,” Dr Mathur added.