Many people with epilepsy may want to know whether and how they can live a fairly normal life. It’s true that life with epilepsy can vary quite a bit depending on how severe it is and how well-controlled the seizures are. As a doctor who has treated people with epilepsy aged 6 and older, I have rarely advised any of my patients to avoid pursuing their goals, dreams or favorite activities. I have seen firsthand many patients who are living very successful and happy lives. That said, I do advise caution, especially with activities that are dangerous and require extra care. It requires taking medications as prescribed, getting regular monitoring, and making routine follow-up visits with your doctor.
It’s mostly a matter of common sense: if you are riding a horse or a bicycle, wear protective head gear and make sure to bring a friend with you. Never go swimming or hiking alone. If you lose consciousness, or lose control of your limbs due to a seizure, you need someone with you to make sure you are safe.
There are a few additional tips that you should keep in mind:
- Carry medical identification. There are many different ways to do this: wear a bracelet, put a notice in your smart phone, put your medical information in your wallet. Such precautions may be essential in the event you cannot speak during a seizure
- Avoid engaging in high-risk activities by yourself. Always bring a friend or partner with you on your adventures
- Try to avoid alcohol. Alcohol can interact with some of the anti-epileptic medications. Alcohol also affects your nervous system and quietens down the electrical activity in your brain. The interaction of alcohol and anti-epileptic medication can compound the effects of your seizure medication and the alcohol; and therefore, you may become more quickly intoxicated and even risk respiratory depression or death
- Keep your home safe, and remove any potential dangers. Avoid glass tables, small rugs or clutter. Consider not locking the door to your room or bathroom in case someone needs to come in to help
Making sure your seizures are under control, with consideration to your quality of life, is key. It’s important to work with your healthcare team to find a treatment plan that works for you. Keep in mind that certain medications might work for one person but they might not be right for you.
Also, do not stop taking your medication without first consulting your doctor, and never take more than you are prescribed. Anti-epileptic drugs work by affecting the activity in your brain, and only your doctor can safely prescribe how much you should take. Finally, let your healthcare team know if another doctor prescribes a new medicine, even something as simple as an antibiotic. Some medications can interfere with your anti-epilepsy medication.
Driving and Epilepsy
Many people with seizures are concerned about the impact epilepsy has on their ability to drive. Generally people with well-managed epilepsy (as demonstrated by an appropriate seizure-free period and compliance with treatment and other recommendations) may be considered fit to drive a private vehicle.
The National Transport Commission of Australia provides guidelines for all Australian states and territories as well as New Zealand. These guidelines are intended to protect your safety and the safety of the community. Each application is considered individually. The period that you must be seizure free before driving depends upon your type of epilepsy and the circumstances surrounding any recent seizure you might have had.
Different licenses have different regulations. There are two sets of rules, one for drivers of private vehicles, and one for drivers of commercial vehicles. Professional drivers such as drivers of trucks, public passenger vehicles and vehicles carrying dangerous goods must meet higher medical standards because of greater safety concerns.
The unpredictable nature of seizures can cause concern or stress about when the next seizure may occur. In addition, many patients with epilepsy have concern about their disorder causing them embarrassment, and how it may affect their work, social, family life. However, accepting the social reality of epilepsy and being prepared if in case you experience a seizure in public or at home may be one way to help you to feel more comfortable with your condition. Some people might not be aware of seizures, be afraid of them or not know what to do. So it’s important to educate those closest to you about your condition: family, friends, classmates, roommates, and potential romantic partners.
All in all, for many people, it may be possible to live a healthy, happy life with a little preparation and information to keep your seizures under control. Work with your healthcare team to find the support and information you need.
Margaret L. Frazer, MD is a neurologist and Senior Director within the Cardiovascular and Metabolic team at Pfizer.