Can caffeine excess cause seizures?

Can Caffeine Excess Cause Seizures?

Yes, excessive caffeine consumption can trigger seizures in susceptible individuals, particularly when consumed in high quantities exceeding 400 mg daily in adults or 2.5 mg/kg body weight daily in children and adolescents. 1

Caffeine and Seizure Risk

• Caffeine is a central nervous system stimulant that can lower the seizure threshold when consumed in excessive amounts 2, 3
• High caffeine intake (>5 mg/kg body weight daily) is associated with increased risk of anxiety and withdrawal symptoms in children, which may contribute to seizure susceptibility 1
• Caffeine's effects on seizure risk appear to be dose-dependent - moderate consumption may be safe while excessive consumption increases risk 3
• Caffeine can be used therapeutically in controlled medical settings to augment electroconvulsive therapy (ECT) by lengthening seizure duration, demonstrating its potential to affect seizure activity 1

Safe Consumption Guidelines

• For healthy adults, caffeine consumption should be limited to ≤400 mg daily (approximately 4-5 cups of coffee) 1
• For children and adolescents, caffeine should not exceed 2.5 mg/kg body weight daily 1
• Pregnant women should limit caffeine intake to ≤200-300 mg daily 1
• Patients with epilepsy or a history of seizures should be particularly cautious with caffeine consumption 4, 3

Mechanisms and Risk Factors

• Caffeine blocks adenosine receptors, which may increase neuronal excitability and potentially lower the seizure threshold 3
• Caffeine can interact with certain antiepileptic medications, potentially reducing their efficacy, particularly topiramate 5, 3
• Individuals with pre-existing seizure disorders may be more vulnerable to caffeine's seizure-inducing effects 4, 6
• Excessive caffeine consumption (>10g) can be lethal and may cause seizures before reaching lethal doses 1

Clinical Considerations

• Caffeinated energy drinks pose a particularly high risk due to their high caffeine content and should be avoided by patients with epilepsy or seizure history 4
• Caffeine is listed among substances that may cause elevated blood pressure and potentially contribute to neurological complications 1
• In patients experiencing unexplained seizures, clinicians should inquire about caffeine consumption patterns 1
• Patients with recurrent seizures should be evaluated for potential triggers, including excessive caffeine intake 1

Special Populations

• Patients with 22q11.2 deletion syndrome have a higher lifetime prevalence of epilepsy (5-7%) and may be more susceptible to seizure triggers including medications and potentially caffeine 1
• Adolescents have a lower seizure threshold compared to adults and may be more vulnerable to caffeine's effects on seizure activity 1
• Patients taking medications that interact with caffeine should be counseled about potential risks of combining these substances 5, 6

While moderate caffeine consumption appears safe for most individuals, excessive intake should be avoided, particularly in those with seizure disorders or other risk factors for seizures 2, 4, 3.