Introduction

Epilepsy is a neurological disorder that could affect work capacity in different ways. It can remain as a hidden condition and if you are well-controlled you can choose almost every job. Although this, some jobs are not suitable for people with epilepsy and people with disabilities. Restrictions could be related to physical effort or to some specific factors that could trigger or favour seizure onset. The choice of the right job stands in a complete self-assessment, together with your neurologist guidance. Self-assessment means understanding your disease and its consequences and, also, defining your abilities considering your education.

The first thing to evaluate when choosing your job is seizure control. If you are seizure free, you could apply for every job you want, without any problem. On the other hand, if you suffer from frequent seizures, you should avoid some specific kinds of jobs, based on seizure type, frequency and consequences.

For example, when suffering from tonic-clonic seizures, tonic seizures, atonic seizures you should consider fall risks, avoiding working with potentially dangerous machinery and tools, blades or at high altitudes. Even when you have absences or focal seizures with awareness impairment, you could fall, or your concentration could be impaired; thus, you should avoid working with dangerous machinery or high altitudes.

As for focal seizures, it depends on the type of the “system” involved. Sometimes they consist simply in the so-called aura, and it could be limited to physical symptoms (epigastric sensation/pain/paresthesia), auditory symptoms, visual symptoms. In these cases, you just have to wait for the end of the seizure; but, in some other cases, the seizure is not limited to the aura, and it precedes the seizure (with motor/cognitive symptoms), thus it could be an occasion to warn people around you and put you in a safe place. If the seizure does not end with aura, you should consider the same risks of other types of seizures. Whereas, if the seizure is limited to the aura, you could experience symptoms which could not hamper your capacity to work, except for the post-ictal period.

Focusing specifically on driving limitations, they are strictly linked to seizure frequency.

 In general, people with a well-controlled disease should have no restrictions for jobs; but jobs involving driving, working around dangerous machinery or flying can pose some issues. Where driving is concerned, it is important to distinguish between having epilepsy and having seizures. A person with fully-controlled epilepsy who is taking anti-seizure medication(s) and is seizure-free for 12 months is legally entitled to drive motor vehicles for the purpose of personal transport. Thus he/she should not experience any restriction as in daily life for personal      use. A person who is fully adherent to medical treatment but experiencing seizures is not allowed to drive in daily life and, even, for working. As a consequence, if you still suffer from frequent seizures, you should avoid jobs involving driving and dealing with machinery. As for machinery, restrictions are similar to those posed for driving, but a specific warning concerning seizures happening in the work environment should be taken into account. If possible, it is better to not work near dangerous machinery, especially if your disorder is not well-controlled and you are at risk of having a seizure, since during the event you could not control movements and environment all around you. The law is usually more restrictive for those jobs, which require driving heavy trucks and public transport vehicles. It usually requires the absence of seizure from 10 years and an EEG without any epileptiform abnormality.   (see 3rd paragraph – provided materials).

As for reaching your job, if you suffer from frequent seizures and you cannot drive, you could, for example, ask to work from home or for disability advantages for public transport.    

Also, some specific jobs are not suitable for people with epilepsy: as an example, for forced army, if you still have seizures, you cannot participate in. We could consider some exceptions: if you had epilepsy as a child or had a single seizure more than 10 years ago (remission), it is possible that you can join the army.

Although this, no blanket restrictions should be posed, and you should take in account your educational level to guide the right choice.