About 25% of epilepsy cases are potentially preventable, according to the World Health Organization. Since epilepsy has many different causes, prevention isn’t a single action but a collection of strategies that protect the brain at every stage of life, from pregnancy through older adulthood. Some causes, like genetic conditions, can’t be prevented. But the ones tied to brain injuries, infections, strokes, and complications during birth often can be.
Protecting the Brain From Injury
Traumatic brain injury is one of the most common preventable causes of epilepsy, particularly in young adults. The more severe the injury, the higher the risk. After a severe TBI, the chance of developing seizures within the first week is roughly 11% higher than in people without a brain injury. Even mild and moderate TBIs carry some risk, though it’s much smaller.
What matters here is that early seizures after a head injury can be treated with medication, but that treatment doesn’t prevent epilepsy from developing later. Seizure-prevention drugs given in the hospital reduce the risk of seizures in the first week after injury, yet they have no effect on whether someone develops epilepsy months or years down the road. The only reliable way to reduce post-injury epilepsy is to prevent the injury itself.
The practical steps are straightforward: wear a seatbelt every time you’re in a car, use a helmet when cycling, skateboarding, skiing, or riding a motorcycle, and take fall-prevention measures if you’re older or caring for someone who is. Securing rugs, improving lighting, and installing grab bars in bathrooms can meaningfully reduce fall risk. For contact sports, following concussion protocols and allowing full recovery before returning to play helps limit cumulative brain damage.
Staying Up to Date on Vaccines
Brain infections, specifically meningitis and encephalitis, can cause lasting damage that leads to epilepsy. Several routine childhood vaccines directly protect against the organisms most likely to cause these infections. Pneumococcal, Hib (Haemophilus influenzae type b), and meningococcal vaccines guard against the bacteria responsible for severe bacterial meningitis. Measles, mumps, rubella, and varicella vaccines protect against viruses that can cause encephalitis and meningitis.
In parts of the world where parasitic infections like neurocysticercosis are common (caused by a tapeworm that can infect the brain), basic hygiene measures, clean water access, and proper food handling serve a similar preventive role. For most people in high-income countries, though, keeping up with the standard vaccination schedule is the single most effective way to prevent infection-related epilepsy.
Reducing Stroke Risk
Stroke is the leading cause of new-onset epilepsy in people over 60. When a stroke damages brain tissue, the scarred area can become a source of abnormal electrical activity that triggers seizures weeks, months, or even years later. Preventing the stroke prevents the epilepsy.
The major modifiable risk factors for stroke are high blood pressure, high cholesterol, diabetes, smoking, heavy alcohol use, obesity, and physical inactivity. Managing blood pressure alone eliminates a large portion of stroke risk. Regular exercise, a diet rich in fruits, vegetables, and whole grains, not smoking, and keeping alcohol intake moderate all contribute. If you already have conditions like atrial fibrillation or diabetes, working with your doctor to manage them well further lowers your stroke risk and, by extension, your risk of developing epilepsy later.
Prenatal and Birth Care
Some epilepsy originates from brain damage that occurs before or during birth. Oxygen deprivation during delivery, infections during pregnancy, and complications like preeclampsia can all injure a developing brain. Consistent prenatal care helps catch and manage these risks early.
For women who already have epilepsy, managing seizures during pregnancy is critical for protecting the baby’s brain. Seizures during labor can cause oxygen deprivation for both mother and baby, so maintaining seizure control through labor and delivery is a priority. Pain management during labor also plays a role, since sleep deprivation, dehydration, and stress can lower the seizure threshold. Continuous fetal monitoring is recommended for women at high risk of seizures during labor so that any signs of fetal distress are caught quickly.
Good prenatal nutrition, including adequate folic acid, avoiding alcohol and recreational drugs during pregnancy, and attending regular prenatal checkups all reduce the chance of complications that could lead to epilepsy in the child.
Managing Febrile Seizures in Children
Febrile seizures, the convulsions some young children experience during high fevers, are frightening to witness but mostly benign. About one-third of children who have a febrile seizure will have another one during early childhood. The risk of recurrence is higher in children who had their first seizure at a very young age, had only a low fever at the time, have a family history of febrile seizures, or had developmental concerns before the first episode.
Despite how alarming they look, simple febrile seizures carry a low risk of leading to epilepsy. Treating fevers promptly with appropriate doses of fever-reducing medication and keeping a sick child hydrated are sensible steps, though no intervention has been proven to eliminate recurrence entirely. The key reassurance is that most children who have febrile seizures do not go on to develop epilepsy.
Alcohol and Substance Use
Heavy, long-term alcohol use is a well-established risk factor for epilepsy, both through direct brain toxicity and through the danger of withdrawal seizures. When someone who drinks heavily stops abruptly, the brain, which has adapted to the constant presence of alcohol, can become dangerously overexcitable. Withdrawal seizures typically occur 12 to 48 hours after the last drink and can be life-threatening.
If you drink heavily and want to stop, doing so under medical supervision is important. Doctors can use medications to ease the withdrawal process and prevent seizures. Beyond withdrawal, reducing alcohol consumption to moderate levels (or abstaining entirely) lowers the long-term risk of alcohol-related brain damage and the epilepsy that can follow. Recreational drugs, particularly stimulants like cocaine and methamphetamine, also lower the seizure threshold and can cause seizures even in people without epilepsy.
Genetic Risk and Family Planning
Some forms of epilepsy are inherited, and while you can’t change your DNA, genetic counseling can help families understand their risk. If epilepsy runs in your family, especially if multiple relatives are affected or if a specific genetic syndrome has been identified, a genetic counselor can assess the likelihood of passing it to children.
Counseling sessions typically cover recurrence risks for the person with epilepsy, risks for future pregnancies, and whether other family members should be tested. The American Epilepsy Society notes that pre-test counseling is particularly important because genetic testing can reveal unexpected findings, including carrier status for conditions that may not have been on anyone’s radar. Genetic testing is generally not recommended for children who don’t have symptoms, but it can be valuable for adults making reproductive decisions.
What Can’t Be Prevented
It’s worth being honest about limits. The majority of epilepsy cases, roughly 75%, are not currently considered preventable. Many arise from genetic mutations that occur spontaneously, from brain malformations that develop during fetal growth for reasons that aren’t fully understood, or from causes that remain unknown even after thorough evaluation. For these cases, the focus shifts from prevention to early diagnosis and effective treatment, which can dramatically improve quality of life even when the condition itself couldn’t have been avoided.