Introduction

During working hours people with epilepsy could face risks related to the environment, similar to those faced by the general population, but some special ones should be taken in account, especially those related to seizures and injuries linked to sudden falls. Risks to safety depend on what your epilepsy is like and what the job involves. As for facing seizures, if possible, it could be useful to develop a Seizure Action Plan and share it with your employer and/or colleagues. Good information and knowledge help people to react properly to seizures. By developing this plan, everybody could be able to help you during and after a seizure, avoiding serious injuries. People around you should stay calm, keep you away from dangers and protect your head from injuries. They should also time your seizure, calling an ambulance if the seizure lasts more than 5 minutes. They should not put something in your mouth or try to restrain you. Finally, after the seizure they should reassure you and help you with something you miss because of the event. 

Some hazards and risks are related to seizures triggering factors. Indeed, some seizures (the so-called reflex-seizures) are related to specific stimuli (sounds, startle and light, commonly). In these cases, you should avoid triggering factors and accommodation are necessary: for example, your employer should allow you to work in an environment away from disturbing sounds, flickering lights or startle elements if you need. Together with your neurologist and your employer you could adjust your work environment to work as safely as possible.

Photosensitivity is a special feature of some generalized epilepsies: when a person suffers from photosensitivity, flickering lights must be avoided, your employer could aid you in making screens and lights safe. Some people with epilepsy could be specifically sensitive to visual patterns, such as chequered     , striped patterns and in general geometrical moving patterns (e.g.escalators, swirling figures in motion, etc).

Another specific reflex epilepsy could be related to reading. If reading is a triggering factor, you should, obviously, do not apply for jobs requiring this stimulus.

A special consideration must be done about motor and sensory limitations: some transient limitations are related to seizures or post-seizure period (as an example Todd paralysis which presents after some seizures). As for motor limitations, you could choose jobs not involving manual skills but cognitive ones. Furthermore, some deficits could be permanent, especially as for people who undergo surgery for epilepsy: they can develop visual, motor deficits. In these cases, you could ask for a pension if you develop deficits that do not allow you to work. On the other hand, if you have only mild deficits, you could just ask for adjustments: providing auditory support in case of visual deficit or removing barrier if you present a motor deficit.

Another important aspect of epilepsy is the effect on cognition, memory and IQ.

Some epileptic syndromes are linked to cognitive deficits. In other cases, you could experience transient issues with memory, cognition and speed of thought related for example to absence seizures/temporal lobe seizures. In these cases, we could suggest avoiding jobs requiring higher mental effort, as for manual ones. Otherwise, especially if the deficit is mild or transient, you just need to rest and recover after seizures or to ask things more than once to work normally. Another key factor to consider is the effect of the drugs on concentration and fatigue. You could ask your neurologist to avoid drugs impairing more attention and concentration, adjusting your therapy. Seizures are unpredictable, also when all triggering factors are avoided, they could happen abruptly, disturbing normal functions. During seizures you could experience falls and injuries, but also you may feel a bit dizzy, fatigated or confused.

Even time shifts could influence your working capacity, and, in some cases, seizures are related to “time”, for example they present only during night or early morning. Indeed, sleep deprivation could be a triggering factor for seizures, especially if you suffer from generalized seizures. To have the most suitable atmosphere it’s possible to consider distance work for jobs not requiring doing things in presence, and sometimes this could be a solution to avoid excessive fatigue and stress. Redistributing time shifts and avoiding night shifts could be two tools to avoid seizures.

We will give you a scheme to evaluate environmental and personal limitations to deal with.