Epilepsy and risk

Epilepsy is a common neurological condition in which a person has a tendency to have recurring seizures. For those people who are at risk of recurring seizures, approximately 70 per cent can usually control their seizures with medication. People who continue to have seizures are more vulnerable to the potential risks associated with seizures, especially when seizures occur without warning and impair awareness. Good seizure control is the first step in reducing the risks associated with epilepsy.

The cause, type and frequency of seizures vary. Assessing potential risks and how to manage them will involve considering all aspects of a person’s seizures, such as seizure type, frequency, severity, when they occur and what impact they have on the person’s awareness. The person’s lifestyle, including occupation and leisure pursuits, will need to be considered as part of the risk assessment.

In the workplace and at school

Employers, schools and other organisations in the community are sometimes concerned about the safety of people with epilepsy. Policies should acknowledge that epilepsy and the associated risks vary from person to person diagnosed with epilepsy. The strategies for minimising risk need to be realistic, appropriate and practical, allowing for individual differences.

Seizures are not as harmful as they may appear

Many people who witness a seizure fear that the person may be harmed by the event, especially if they witness a tonic clonic seizure (formerly known as a ‘grand mal’ seizure). However, the risk of brain damage or death from a seizure is low. A person is most at risk of harm if they are doing something dangerous when a seizure occurs, especially if their awareness is impaired during the seizure.

Injury

Anything that affects a person’s conscious state, awareness or judgement can increase the risk of accidents. Following a seizure, the doctor will make recommendations in relation to driving, the use of dangerous machinery, working above ground level and general safety issues. The advice will be based on the person’s medical assessment.

Driving

If you have epilepsy or seizures, you can hold a learner’s permit or driver’s licence for private vehicles as long as your seizures are well controlled. National medical guidelines have been developed by specialists to assist with the assessment of applications from people with epilepsy or seizures. Each application is considered individually. If you hold a current learner’s permit or driver’s licence you are required by law to notify VicRoads if you have or develop any serious chronic medical condition such as seizures and epilepsy.

Swimming and bathing

Always swim with a friend or have someone watching you who knows that you have epilepsy and is capable of rescuing you. Have a shower instead of a bath and take special care when you use hot water. Good safety hints for any home are to turn on the cold tap first in the shower or basin and lower the temperature of the hot water service.

Check for hazards

Take the time to think about your home, work and leisure activities. What are the potential dangers if a seizure occurs? How can you reduce the risk of harm to yourself or others? There are many general safety strategies that can help, for example:

• Use smoke alarms
• Install fireguards
• Get an electrician to install a circuit breaker
• Use anti-slip mats in the shower and shower screens designed to minimise injury if someone falls in the bathroom. You may also consider using a shower chair
• Wear a bicycle helmet when riding.

You may find it helpful to work through a checklist from the Epilepsy Foundation of Victoria or community safety organisation.

Emergency identification

Some people choose to wear a specially-designed medical alert bracelet or pendant with epilepsy information, in case of an accident. Another option is to carry medical information in your wallet.

Status epilepticus

Most seizures are spontaneous, brief and self-limiting. Status epilepticus refers to a prolonged seizure, or cluster of seizures, which occur one after the other in quick succession without recovery between the episodes. Status epilepticus is uncommon but can be life threatening or cause brain damage, especially with convulsive status epilepticus.

This is a medical emergency and must be treated urgently. Dial triple zero (000) to call an ambulance if a seizure continues for five minutes or more, unless the person has an epilepsy management plan that advises you to do something else.

Death

In recent years, there has been increasing awareness of Sudden Unexpected Death in Epilepsy (SUDEP). The cause of SUDEP is not well understood and it is difficult to estimate the incidence. SUDEP is rare in people with new onset epilepsy and also in people in remission who no longer have active epilepsy. The higher overall risk appears to relate to people with chronic epilepsy.

Some key risk factors for SUDEP are:

• 20–40 age group is at greatest risk
• Generalised tonic clonic seizures
• Seizures at night
• Poorly-controlled seizures
• Abrupt and frequent changes of medication in people whose seizures are not well controlled or who do not take their medication as instructed by their doctor.

Reducing the risks

Some prevention strategies include:

• Have regular medical reviews of your epilepsy, especially if you experience ongoing seizures
• Learn about your epilepsy
• Tell your doctor if you are having seizures
• Follow your treatment plan and tell your doctor if you are having unpleasant or serious side effects. A rash can be a sign of a serious allergic reaction
• Identify and avoid any seizure triggers, such as lack of sleep or excessive alcohol intake
• Adopt good general safety strategies
• Identify and reduce potential hazards where possible
• Give detailed first aid instructions to those who might support you
• Consider using a seizure alarm for nocturnal convulsive seizures
• Never abruptly stop taking your medication unless advised by your doctor
• Showering is safer than bathing
• Never swim alone and always ensure you are swimming with someone capable of rescuing you
• Cease driving if you have a seizure until you have been cleared by your doctor and VicRoads.

Where to get help

• Your doctor
• Neurologist
• Epilepsy Foundation of Victoria Tel. (03) 8809 0600
• Epilepsy Helpline Tel. 1300 852 853

Things to remember

• Epilepsy is a common neurological condition in which a person has a tendency to have recurring seizures.
• Risk management for people with epilepsy needs to take into account the unique circumstances of each person.
• Good seizure management will help reduce epilepsy risks.

You might also be interested in:

• Nervous system.
  
• Neuromuscular system.
  

Want to know more?

Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)

Epilepsy Foundation of Victoria Incorporated

Fact sheet currently being reviewed.
Last reviewed: August 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epilepsy_and_risk?open">Epilepsy and risk - Better Health Channel</a><br/>
Epilepsy is a common neurological condition in which a person has a tendency to have recurring seizures. Good seizure management is essential to reduce the risks associated with epilepsy. A seizure is not usually dangerous, but a person is at risk if they are in a dangerous environment and they have impaired awareness or are unconscious. Injury may occur in the home, workplace, school or elsewhere. Driving can be dangerous, and swimming and bathing also carry risks.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

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