ABOUT EPILEPSY - LIVING WITH EPILEPSY

Can people living with Epilepsy lead normal lives?

Experience has shown that people with Epilepsy have fewer seizures if they lead normal active lives. This means they should be encouraged to find jobs, either full or part-time. People with any disabilities are now protected under amendments to the Human Rights Code (Canada). However, some jobs, because of the nature of technical equipment or machinery, may not be recommended for a person with Epilepsy. It is therefore most important for a young adult to work with the school guidance department to establish appropriate career goals.

What can people with Epilepsy do to help their health?

Like any medical condition, Epilepsy is affected by the general health and well-being of the person affected. So, anything that can be done to improve the state of the person can have a positive effect on Epilepsy. This includes diet, exercise, rest, reducing stress, avoiding depression, and staying away from alcohol and illegal drugs.

Who should know that I have Epilepsy?

Openness and honesty about Epilepsy is important. A child's teacher should be informed about the type of seizure, what they look like, their frequency, and any first aid requirements. There are advantages and disadvantages to telling an employer. What you tell them may depend upon how comfortable you are discussing your Epilepsy, the kinds of seizures involved, and the type of job. An employer may ask if you have a medical problem that would make you unable to do your job, but they may not ask generally about your medication condition.

Is there prejudice against people with Epilepsy?

While much progress has been made in reducing societal prejudice against Epilepsy, discrimination or rejection may also be a problem for the person with the seizures. In addition, family and friends may be overprotective or impose unnecessary restrictions. In the end, the person with seizures may lose confidence or feel "like a second class citizen".

Are there any problems having children?

Women who use seizure-controlling drugs must be careful when it comes to having children. There have been reported cases of birth defects for these women. While the "normal" rate of birth defects is 2-3% , women with epilepsy who are not taking medication have a slightly higher (1/2%) risk of malformations. Women on a single medication have a risk of about 6-7%, with some differences due to the particular medication involved. Multiple drug combinations drastically increase the risk. New research has addressed the issue of birth defects and it has been found that monotherapy and folic acid has markedly reduced this risk from 4% to 2-3%. The risk of birth defects in the general population is 2%. An epileptologist (neurologist who specializes in epilepsy) will help you find the right medication to reduce the chance of birth defects. This creates a problem because the drugs may create risks for the baby, but the need for anti-seizure drugs remains during pregnancy. Seizures may even be more frequent during pregnancy, and harm both the baby and the mother. A doctor may decide to change or reduce a woman's medication if she plans to become pregnant. In some cases, however, the doctor may recommend that the risks of pregnancy are too great for the mother and child. Any changes in medication must be considered carefully, and a woman should never adjust her own medication.

There are some special issues relating to maternal health during pregnancy for women with Epilepsy, and this may require special attention. Finally, some seizure medications can lead to failures of oral birth control pills.

Can medications for controlling Epilepsy harm a nursing baby?

Always check with your physician if you are on anticonvulsants and planning to breast feed. Although anticonvulsant medication has been measured in the breast milk of mothers with Epilepsy, the amount is usually too low to harm the child.

Can people living with Epilepsy drive a car?

Each state has its own requirements for people with epilepsy to drive. Generally, your physician will okay you for a license if the following criteria is met:

1. Completely controlled on medication
2. Have seizures only at night
3. Have seizures which are focal motor
4. Have only auras
5. Have long auras before seizures which allow you to pull off to the side of the road
6. Have predictable seizures that occur during fever, sleep deprivation or another time when you can predict when the seizure will happen
Check with your state's Department of Motor Vehicles for the rules that apply in your state.

In Canada, the situation is that anyone with a history of Epilepsy may drive a motor vehicle, provided the person's physician certifies that he or she has been free from seizures for a minimum period of a year. Each case is reviewed by a medical advisory committee. The situation may be different in your location. Ask your physician about it, or contact a driver examination center.

Can people living with Epilepsy go swimming?

It is advised that before a person with Epilepsy goes swimming, they should consult their doctor. When a person with Epilepsy does go swimming, they should not do it alone (common water-safety advice for everyone). It is also recommended that swimming be done in a supervised pool rather than beaches, lakes, or rivers.

Can Epilepsy lead to problems at school?

Longstanding seizure disorders may be associated with seizure-induced brain damage and memory problems. Also, children with Epilepsy may experience learning or concentration problems because of the neurological disorder or the medications.

If a child who has Epilepsy is having problems at school, either academically or socially, the teacher and the principal should be asked to help. If you would like your child to be tested by the school psychologist, arrange it through the principal. If your child is having academic problems, ask to see the Special Education Consultant for the area. In consultation with the child's teacher, a modified program can be arranged if necessary. Children with Epilepsy should be allowed to take part in all regular school activities, including sports.

Can Epilepsy cause emotional problems?

People with Epilepsy may develop depression for both biological and social reasons. Some longstanding poorly controlled seizure disorders may be associated with chronic personality changes. Also, or short durations following temporal lobe seizures some patients may have emotional "swings" or other thinking difficulties.

While Epilepsy is a medical problem, the person with the seizures must also make a number of emotional adjustments. The first challenge is acceptance of the diagnosis. Initially people with Epilepsy and their families may experience shock or denial. Anger, fear, and depression are also common. However, with information and support, people with Epilepsy can understand the condition and develop positive coping strategies.

Can Epilepsy lead to problems with self-esteem?

It is important to remember that people with Epilepsy can, and do, live full, productive lives. If self-esteem becomes a problem, open discussion with supportive friends, family, or a professional counselor can help you develop new ways of coping and a new sense of hope.