With the arrival of summer, and as states move to open up, chances are some of your patients are planning a little well-earned fun in the sun. As a clinician, it’s paramount you alert them to potential risks associated with scorching heat — and convey steps to steer clear of danger.

For one, there is evidence to suggest that epileptic seizures are more common in hotter temperatures. A 2020 study in Neurology and Neurobiology identified a “significantly higher rate” of these incidences in spring and summer. (The investigators did note, however,  that exploration on the matter is fairly limited and that “further research combining different weather conditions and environments is needed to fully characterize the seasonality of epilepsy.”)1

For another, some patients may be particularly sensitive to heat, and seizures can result from heatstroke (a core body temperature that meets or exceeds 104°F).2 “The brain doesn’t function as well at higher temperatures,” notes Vikram Rao, MD, PhD, assistant professor of neurology at the University of California, San Francisco.3 If the brain misfires at elevated temperatures, it can trigger a seizure.


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So, although every patient is unique and risk levels vary depending on myriad factors such as diet and stress, there are certain things every patient can do to stay a little safer when it’s hot out. Here are some key summer safety tips4 to share with them:

1. Play it cool

Whether or not your patients are particularly sensitive to heat, advise them to take the following precautions.

  • Limit sun exposure: Recommend that your patients partake in outdoor activities early in the morning or later in the evening to avoid midday high temperatures.
  • Stay hydrated: Your patients should drink four-to-six cups of water per day,5 and always stay hydrated before, during, and after exercising.
  • Listen to their body: Advise your patients to rest in a shaded or air-conditioned area if they feel thirsty, weak, or dizzy.

2. Prepare before going in (or out on) the water

Swimming and water sports are excellent options to stay cool, but there are certain precautions your patients should take.

  • Swim with a friend or loved one: Advise your patients to avoid swimming alone. Instead, they should swim with someone who is able to respond quickly in the event of an emergency.
  • Inform lifeguards: If they’re swimming in a public space, your patients should alert the lifeguard ahead of time of their condition.
  • Check safety equipment: If they’re planning to go rafting, boating, water skiing, surfing, or partake in another activity out on the water, remind your patients to check their life jackets and floatation devices ahead of time.

3. Travel smart

If their summer plans include a getaway, encourage your patients to plan ahead for easier travel6. They should:

  • Follow a medication routine: Flights, long drives, and changes in time zones can throw off medication routines. Work with your patients to establish a plan for staying on track and remind them to pack extra medication in case they encounter travel delays, or changes in plans.
  • Communicate: If they’re flying, advise your patients to notify the TSA of any medically necessary liquids before screening. Encourage your patients to let the cabin crew and the person sitting next to them know how to assist should a seizure occur.
  • Wear a medical ID bracelet: Medical identification cards or jewelry can alert passersby to your patient’s condition and help emergency personnel understand how to assist more quickly.

Takeaway

Epilepsy affects every patient differently, but the aforementioned tips are beneficial to share with all patients, in addition to stressing the critical importance of planning ahead and keeping in communication with you.

References

1. Verentzioti A, Slatouni A, Alexoudi D, et al. Seasonal pattern of epileptic seizures: a single-center experience. Journal of Neurology and Neurobiology. 2020; doi: 10.31487/j.NNB.2020.02.03

2. Heatstroke. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581. August 18, 2020. Accessed June 9, 2021.

3. Masters M. 6 things that can trigger a seizure even if you don’t have epilepsy. Health. https://www.health.com/mind-body/6-things-that-can-trigger-a-seizure-even-if-you-dont-have-epilepsy. Updated March 22, 2016. Accessed June 9, 2021.

4. Kiriakopoulos E. Summer safety for people with seizures. Epilepsy Foundation. https://www.epilepsy.com/article/2018/7/summer-safety-people-seizures. July 11, 2018. Accessed June 9, 2021.

5. How much water should you drink? Harvard Health. https://www.health.harvard.edu/staying-healthy/how-much-water-should-you-drink. March 25, 2020. Accessed June 9, 2021.

6. Orenstein BW. 11 ways to make travel safer if you have epilepsy. Everyday Health. https://www.everydayhealth.com/epilepsy/11-steps-for-easier-travel-with-epileps.aspx. Updated September 30, 2018. Accessed June 9, 2021.

This article originally appeared on Neurology Advisor