How Do You Approach Seizures in the High Altitude Traveler?

Abstract

Counseling patients who suffer first-time or break- through seizures can be difficult, particularly when controllable external factors may be contributing to the lowering of their seizure threshold. High altitude as a potential trigger for seizures is a common question in our epilepsy clinics in Colorado, and this article reviews the existing anecdotal literature, presents our local experience with high altitude seizures (HAS), offers possible mechanisms to explain how high altitude may trigger seizures, and suggests an initial work-up and prophylactic strategies for future high altitude exposures.

Isolated Generalized Tonic-Clonic Seizure at High Altitude in a Young Male Trekker with a Positive Family History of Seizure

“…A number of anecdotal reports and small studies describe the occurrence of seizures at altitude and have suggested potential risk factors including sleep disturbance (Maa, 2010), hyperventilation (Daleau et al, 2006Maa, 2011), and the direct effects of hypobaric hypoxia (Maa, 2011). Hypoxemia may have lowered the seizure threshold in this individual, something with potential implications for any person with either a personal or family history of seizure activity that is considering travelling to altitude.…”