Epilepsy is a common neurological disorder characterised by “an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure”. A seizure is defined as “a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain” (Fisher et al., 2005). Symptoms occurring during the seizures could be various different, depending on the brain area involved and, basing on neuronal network generating the seizure, it is possible to distinguish: focal onset seizures (with or without awareness impairment) and generalized onset seizures. Thus, beyond the typical representation of generalized tonic-clonic seizures, epileptic events could lead to other kind of symptoms: sensory/motor/auditory/visual symptoms, involving or not subject’s awareness (e.g., absences or temporal lobe seizures). Similarly, epilepsy etiologies could be disparate and different (genetic, metabolic, structural, infectious, autoimmune…). A third level of the ILAE classification include also specific syndromes, often related to age of subject. As previously stated, a seizure could have different manifestations. In general, as for generalized tonic-clonic seizures, tonic/atonic seizures (seizures in which the subject becomes “rigid” or “flaccid”, respectively), people could be at risk of falling. Some little tips could aid you to help a person experiencing such kind of seizures. First of all, you should protect the person head, putting something soft under the head, trying to avoid brain injury. You should not put anything inside the mouth of the subject or try to restrain him/her during a seizure. You should also put the person in lateral position, in order to avoid airways’ obstruction. As for focal seizures with or without awareness impairment, you should protect the person leading him/her away from dangerous things, waiting for the end of the seizure and reassuring him/her. Both for generalized or focal seizures, in some cases is necessary to call emergency service:

• Seizure with loss of consciousness longer than 5 minutes,
• not responding to rescue medication if available
• Repeated seizures longer than 10 minutes, no recovery between them
• Difficulty breathing after seizure
• Serious injury occurs or suspected (e.g. brain injury)
• First time seizure

Apart from seizures, people with Epilepsy (PwE) usually have to face with other challenges during daily life. They must take a chronic therapy (anti-seizure medications, ASMs) with specific times and follow a regular follow-up with neurologists, sometimes repeating electroencephalograms and MRI. ASMs do not treat the disorder, but they are used to reduce the risk of seizure recurrence. When medical therapy is not sufficient to control seizures (30% of cases), they should undergo surgery. Both for surgical patients and for non-surgical patients, seizure control stands in regular follow-up with neurologists, thus it could be advisable to allow PwE attending medical visits and exams (EEGs and MRIs), providing them time-off for visits. They could also experience limitations related to cognitive and physical effects of seizure. As an example, some syndromes and some drugs could lead to cognitive disfunction/memory loss or concentration difficulties. Furthermore, you should also take in account seizure’s triggering factors to make simple accommodations to avoid dangers. Some seizures could be caused by flickering lights, or sudden sounds; sometimes reading or sleep deprivation could facilitate seizure onset. Adjusting lights, avoiding triggering factors and reorganizing shifts to avoid sleep deprivation and excessive stress could be some of the strategies to make work easier and more comfortable for PwE. If the person suffers from frequent seizures, he/she could not be allowed to drive, thus, smart-working – whenever possible – could be a solution for them to continue working. Although some limits, no blanket job restrictions should be posed, and, often PwE can work normally, as the general population, especially if they are seizure free. Even if advances in diagnosis and therapy allow the vast majority of PwE to reach seizure control (about 70%), workplace inclusion for PwE is still hard to manage. Most of the social issues they face are related to misconceptions, stigma and ignorance. We can state that beyond accommodations you can take, a key factor to include PwE in workplaces is developing inclusion and educational programs aimed to increase knowledge of epilepsy among employers, caregivers and institutions.