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Questions from healthcare professionals

Q: My organisation is a managing agency which facilitates apprenticeships for the construction industry. We have applicants and apprentices with epilepsy and we strive to develop best practice in how we support the individuals involved as well as establish an understanding of the condition with employers. What is the best advice for people with epilepsy in terms of disclosing their epilepsy?

A: We have produced information for individuals with epilepsy in respect of employment, which covers disclosing their epilepsy to employers or potential employers.
In general, individuals are not legally obliged to disclose a disability or long-term health condition. However, this needs to be balanced against the benefits of being able to assert their rights under the Equality Act 2010, and the health and safety obligations of the employer.

Useful references:
Employers forum on disability: http://www.efd.org.uk/
The Equality and human rights commission: http://www.equalityhumanrights.com/
The health and safety executive: http://www.hse.gov.uk/
December 2011

Q: I have a client diagnosed with non-epileptic seizures. She has seizures that last for over an hour and may have four episodes in 24 hours. Is there anything that would help to lessen these seizures or the impact they are having on her quality of life?

A: You might like to look at a website for information specifically on non-epileptic seizures. A good website is Non-Epileptic Attacks, which is run by professionals working in this specialist area. You can find out about further support and make contact through the website. It may also be appropriate for the individual to have a referral to a specialist tertiary service, such as the Institute of Psychiatry.
October 2011

Q: Can an employer make or expect an employee with epilepsy to wear a protective helmet in work? If not is an employer liable if the individual has a seizure and injures himself.

A: This is not a simple question to answer. There are two important acts that need to be considered in this scenario: The Equality Act and the Health and Safety a Work Act. When an individual with epilepsy discloses to their employer that they have epilepsy, the employer will need to do an individual risk assessment: looking at the potential risks for that employee, in their particular job, due to the type or types of seizures they have. This effectively avoids blanket restrictions or assumptions being made about the effect of epilepsy and seizures on an individual at work. Alongside this, an employer has responsibilities under health and safety to maintain the safety of all employees. This is also the case when considering employers insurance. In such a scenario, we would suggest that the employer contact the Health and Safety executive, or the employers forum on disability, for specific advice about the individual situation.
You can find the contact details of these organisations on our website here: http://www.epilepsysociety.org.uk/AboutEpilepsy/Livingwithepilepsy/Employment/Employers
July 2011

Q: Can people with uncontrolled seizures on antiepileptic drugs be advised to work? If so, is there a risk to them?

A: Many people with epilepsy can work without any problems and some individuals who have ongoing seizures might need consideration when entering work. When considering work it is important to be aware of the legislation around disability within the Equality Act 2010. This includes not discriminating against someone with a disability in terms of employment. If someone has seizures there are health and safety issues that also need to be considered. It is important that any decisions made about suitability for work are based on each individual's situation, and includes a risk assessment for that person.
You can find lots of information about the Equality Act and how it applies to employers and employees from both our website at http://www.epilepsysociety.org.uk/AboutEpilepsy/Livingwithepilepsy/Employment/Employment and at www.equalityhumanrights.com.
May 2011

Q: Is electrolysis of facial hair contraindicated for people with epilepsy?

A: We are not aware of any contraindications of electrolysis for people with epilepsy. However, it is worth being aware that some people with epilepsy have particular triggers for their seizures so, although it may not be a problem for the majority of people, some people with epilepsy may find this a problem.
September 2010

Q: Is there any link between Vitamin D deficiency and seizures? Is there a recommendation that people with epilepsy take a supplement of vitamin D?

A: So far it is not known whether there is a link between Vitamin D deficiency and seizures. Vitamin D is referred to, in the context of bone health, in the chapter called 'bone health in epilepsy' in the 'outcome' section of articles on this website.
September 2010

Q: I work as a speech therapist specialising in patients with neurological conditions.  I have a couple of patients with epilepsy, presenting with altered speech.  Is there any evidence for which speech therapy approaches are best for people with epilepsy?

A: As far as we are aware, there is no real evidence base for the best approach at this time. However, our speech and language therapist at Epilepsy Society would be happy to discuss this issue with any readers, as she has done some work in this area. You can contact her at nicola.cook@epilepsysociety.org.uk.
July 2010

Q: I work in a school with a 5 year old boy with congenital bilateral perisylvian polymicrogyria.  He presents with global developmental delay and associated epilepsy along with sensory processing difficulties.  One example of his sensory behaviour is that he constantly wants to put his hands in his mouth to the point where it is now effecting his learning and development.  Are there any articles and/or research which would help provide me with an evidence base to develop a sensory programme for this little boy? 

A: Unfortunately this is not something that we can advise on. Individuals with a learning disability may find comfort from repeated actions and this could potentially explain this child's behaviour. Video-EEG telemetry might be a useful way of determining whether his repeated behaviour could be caused by seizure activity.
June 2010

Q: Are there any up-to-date articles on the incidence of epilepsy in the elderly demented patients?

A: There is an article produced for the book 'Epilepsy 2009' available on this website on epilepsy and seizures in geriatric practice. You may also find additional papers on this subject on the PubMed website (opens in a new window). 
May 2010

Q: What is the selection criteria for epilepsy surgery?

A: There are several criteria for epilepsy surgery, including drug-resistant seizures, seizure frequency and severity, likelihood of reducing or stopping the seizures by surgery and any contraindication for surgery. All of which need to be considered on an individual basis and the risk: benefit ratio considered for that individual.

For more information about epilepsy surgery and selection criteria, see our articles on surgical treatment of epilepsy.
August 2009

Q: Can people with epilepsy drink alcohol?

A: Issues around epilepsy and alcohol are not straightforward and are patient specific (different individuals respond differently to alcohol). You can find information about this on this website under 'leisure'. Specific guidelines about anti-epileptic drugs and alcohol can usually be found on the Patient Information Leaflet with the medication, or on the MedGuides website.
July 2008

Q: What are the regulations around employment for someone with epilepsy? Does being seizures-free make any difference to their employment?

A: There are various issues that need to be considered when employing someone with epilepsy. For the employer this includes their responsibilities under the Disability Discrimination Act as well as Health and Safety regulations. You can find more information in the chapter Employment in our articles section. 
April 2008

Q: Are people with epilepsy entitled to free dental treatment?

A: For information about the costs of dental treatment you can look on the websites for the Department of Health  or NHS Choices. The document HC11 Help with Health costs, available via both of these sites, has information on the cost of medical treatment including dental treatment. 
March 2008

Q: Can epilepsy affect someone's memory?

A: For some individuals with epilepsy, their epilepsy, seizures or anti-epileptic medication can all affect their memory. For more information on how epilepsy can affect memory, look at 'epilepsy and memory' on this website.
December 2007

Q: What dose of vitamin D should be recommended for children on AEDs and which preparation is used?

A: Vitamin D is not routinely prescribed. It is still under debate as to when and if DEXA scans should be performed.
February 2007

Q: In the treatment of depression in epilepsy, is Prozac the recommended antidepressant or Citalopram?

A: Citalopram is said to cause fewer problems, however the evidence for this is not firm.
November 2005

Q: Regarding people with epilepsy who have depression, SSRIs and TCAs are both quoted as lowering seizure threshold with topiramate. What is the real risk of seizure threshold being lowered in someone taking topiramate?

A: The risk of the seizure threshold being lowered by an anti-depressant is very low because the person is already taking an anti-epileptic drug.
November 2005

Q: What is the safest medication to give to patients with epilepsy complaining of insomnia?

A: Zopiclone or Temazepam.
May 2005

Q: Are cranberries in any form contraindicated with AEDs or epileptic seizures?

A: We are not aware of any contraindications.
April 2005

Q: My client is afraid her husband is dying every time he has a seizure. Is it possible to die as a result of a seizure?

A: There are around 1000 epilepsy related deaths a year in the UK. Some of these are due to accidents during seizures, but some are a result of Sudden Unexpected Death in Epilepsy (SUDEP). There is more information under Outcome in our articles section. 
December 2004

Q: Are you aware of evidence linking epilepsy and intestinal hormones such as vasoactive intestinal peptide or cellular messengers such as G proteins? Is any research being conducted in these areas?

A: We are not aware of any such evidence, or research in this area.
September 2004

Q: Is the any research/information relating to the effects of high altitude on epilepsy?

A: There has been much anecdotal evidence relating to this, however there is no scientific evidence.
May 2004

Q: Why do seizures usually stop after a few minutes?

A: Research suggests that the brain has a mechanism for stopping seizures. Endogenous opioids are released following partial and generalized tonic-clonic seizures, and it is believed that they contribute to an increase in seizure threshold, helping to end the seizure. The article Basic mechanisms of epilepsy in our articles section may be of interest.
April 2004

Q: Are TENS machines which are used to help pain management contraindicated for people with epilepsy?

A: TENS machines are not contraindicated for people with epilepsy.
March 2004

Please note: Epilepsy Society is unable to provide a medical opinion on specific cases. Responses contain information relating to the general principles of investigation and management. Answers are not, and should not be assumed to be, direct medical advice.