A long list of dos and don’ts for people with epilepsy is of little help. Most of the problems can be solved by using a bit of common sense. It is important to bear in mind that some people have mild epilepsy and others severe epilepsy. Obviously the person who has a fit once a year will approach life a little differently to someone who has a seizure once a week. The factors that need to be taken into account are:
the type of fit;
the severity of the fit;
when the fits occur;
the age of the patient.
When epilepsy is diagnosed, people are often shocked and frightened. This may lead to some degree of overprotection, particularly of children. But once the seizures are controlled and appropriate explanation and advice has been given, their confidence should grow and they should be encouraged to lead as normal a life as is possible. There are some practical points worthy of mention:
Swimming: A person with epilepsy should never swim alone. Always inform a companion of the condition and explain what to do if a seizure should occur. Avoid both scuba and springboard diving.
Bathing: A number of people with epilepsy have drowned in baths. Never leave them alone in the house when they are taking a bath; keep the bathroom door ajar and make sure that the bathwater is reasonably shallow.
Showering: The risks of showering are threefold:
If someone has a grand mal fit in the shower it may be difficult to get at them.
They might push an arm or a leg through a glass panel. Showers should be fitted with the best shatterproof glass. Wire-reinforced glass is in fact weaker than sheet glass.
The hot tap may be turned on fully when bumped during a fit, resulting in burns. Ideally, a temperature control device should be fitted to the water system in the shower.
Bicycle riding: A person with epilepsy can ride a bicycle taking the normal precautions that any other cyclist should be taking. Children who have frequent seizures should wear a helmet and ride in a protected environment.
Horse riding: a person with epilepsy who wishes to ride a horse should wear a helmet and ride with others.
Climbing: Climbing is not a sensible hobby for people with epilepsy for obvious reasons.
Machinery: working with power saws, presses, etc. should be avoided.
Employment may present problems for people with epilepsy. Obviously some occupations are just not suitable for people with epilepsy; driving a bus, working with heavy or dangerous machinery or working on a scaffold would not be sensible. Two factors need to be taken into account: the possibility that those with epilepsy may injure themselves during a seizure or that they may cause harm to others.
What occupations are closed to epileptics? The armed forces will not employ someone with epilepsy. Other examples include occupations such as an airline pilot, public transport driver, crane driver, etc. It is logical and appropriate that people with epilepsy should not be involved in these occupations.
More of a problem is the prejudice against persons with epilepsy. This leads to the perennial problem of whether people should declare their epilepsy or try to hide it. Ideally it is best to declare your epilepsy and hope that the prospective employer will understand. Sadly this is not always the case. This is a real problem and is likely to persist. It is hoped that through the efforts of National Epilepsy Associations and the various State organisations throughout the world, this problem will lessen with the passage of time as public awareness increases. Unfortunately there is no easy solution to this very real problem.
A further problem is that of driving. Today driving a car is an integral part of everyday living. Not being able to drive can be inconvenient and, of course, can limit job prospects. The present legal situation, which is under review, is that a person should have been seizure-free for two years to obtain a driving licence. In some situations, if seizures have habitually occurred only at night for a period of two years, the person may be granted a restricted daytime licence. There are variations from country to country and within countries amongst states and provinces. The general trend worldwide is to individualise the granting of driving licences in a commonsense way. It is important, however, to remember that driving a car is in itself a responsibility and that restrictions are for the protection of epileptics and other road users. Individuals seeking further information on this subject should contact their local Motor Transport Department.
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Epilepsy
