For patients with epilepsy, international air travel sometimes raises concerns. These concerns centre around the risk of seizure recurrence once they arrive at the destination and how to manage their anti-seizure medication in different time zones.
For most patients with epilepsy, seizures occur without warning. This makes predicting when a seizure may occur difficult. However, there are factors that increase the risk of a seizure occurring. Among these risk factors, sleep deprivation is particularly risk for seizures. Sleep deprivation can lower a threshold for a seizure and increase the chance of a seizure occurring. This phenomenon of sleep deprivation increasing seizure risk, is also used in diagnostic testing (electroencephalogram or EEG), to try and help identify seizures.
Sleep deprivation is a particular issue for epilepsy patients traveling internationally. There is insufficient data discussing the risk of seizures after long haul flights. In the few studies that have been done, the greatest risk factor for seizures after long haul flights is how well a patient’s seizures were controlled before they left on their journey. Patients with a higher seizure count before flying had a higher risk of seizures occurring within one week of arrival at their destination. Interestingly, patients who were worried about having a seizure while flying also had an increased risk. Patients who had complete seizure control prior to flying did not experience a seizure once they arrived (Seizure 2006).
When thinking about traveling, ensure that your anti-seizure medication is in you in your carry-on luggage and not in your checked luggage. Ensure you have a sufficient supply for the duration of your trip. Most anti-seizure medicines are designed to be taken twice a day and do not have to be taken exactly 12 hours apart. It would be important however to maintain a regular pattern of taking the medication.
Plan your travel so that adequate rest can be obtained. This may include breaking the journey up with a stopover, and ensuring that once the destination is reached, adequate time for recovery is scheduled to avoid further sleep deprivation. Melatonin is a natural hormone that regulates sleep. In general, melatonin would be considered reasonable to help with travel related sleep regulation if sleeping in the new time zone is difficult.
Finally, it is important to ensure that you have adequate travel insurance. If there are concerns around flying long distance, this may be something you want to discuss with your general practitioner or specialist.
