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==== Triggers and reflex seizures ==== Certain external or internal factors may increase the likelihood of a seizure in individuals with epilepsy. These triggers do not cause epilepsy but can lower the seizure threshold in people who are already susceptible. Common triggers include [[sleep deprivation]], [[Stress (biology)|stress]], fever, illness, [[Catamenial epilepsy|menstruation]], alcohol, and certain medications. These do not cause seizures by themselves, but lower the threshold in people who are already susceptible. A small subset of individuals have [[Reflex seizure|reflex epilepsy]], in which seizures are reliably provoked by specific stimuli. These reflex seizures account for about 6% of epilepsy cases.<ref name="Xue2006">{{cite journal |vauthors=Xue LY, Ritaccio AL |date=March 2006 |title=Reflex seizures and reflex epilepsy |journal=American Journal of Electroneurodiagnostic Technology |volume=46 |issue=1 |pages=39β48 |doi=10.1080/1086508X.2006.11079556 |pmid=16605171}}</ref><ref name="Reflex2008">{{cite book|title=Behavioral aspects of epilepsy: principles and practice|year=2008|publisher=Demos|location=New York|isbn=978-1-933864-04-4|page=125|url=https://books.google.com/books?id=a6Ygv5_RKKsC&pg=PA125|edition=[Online-Ausg.].|editor=Steven C. Schachter }}</ref> Common triggers include flashing lights ([[photosensitive epilepsy]]), sudden sounds, or specific cognitive tasks such as reading or performing calculations. In some epilepsy syndromes, seizures occur more frequently during sleep or upon awakening.<ref>{{cite journal | vauthors = Malow BA | title = Sleep and epilepsy | journal = Neurologic Clinics | volume = 23 | issue = 4 | pages = 1127β1147 | date = November 2005 | pmid = 16243619 | doi = 10.1016/j.ncl.2005.07.002 }}</ref><ref>{{cite journal | vauthors = Tinuper P, Provini F, Bisulli F, Vignatelli L, Plazzi G, Vetrugno R, Montagna P, Lugaresi E | title = Movement disorders in sleep: guidelines for differentiating epileptic from non-epileptic motor phenomena arising from sleep | journal = Sleep Medicine Reviews | volume = 11 | issue = 4 | pages = 255β267 | date = August 2007 | pmid = 17379548 | doi = 10.1016/j.smrv.2007.01.001 }}</ref>
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