Epilepsy - Outlook and Effects

Injuries and Accidents

Injuries from Falls. Because many people with seizures fall, injuries are common. Although such injuries are usually minor, people with epilepsy have a higher incidence of fractures than those without the disorder. Epilepsy patients who take the drug phenytoin have an even higher risk, since the drug can cause osteoporosis.

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Driving and the Risk for Accidents. Being unable to drive is an extremely distressing and severe component of epilepsy. Drivers with well-controlled epilepsy are not at a high or unacceptable risk for automobile accidents. Uncontrolled epilepsy, however, poses a high risk. Needless to say, seizures can be very dangerous if they occur while a person is driving. Studies have reported that more than one-fourth of drivers with uncontrolled epilepsy had an seizure-related accident at some time. One particular study found that over half of these accidents resulted in injuries to the patient or others. In spite of these events, 30% of the patients had driven within the past year, and most drove at least once a week.

Four factors help predict who may safely drive:

A long duration between seizures. In one 1999 study, being seizure-free for six months reduced the risk for accidents by 85%, and being seizure-free for a year lowered the risk by 93%. State laws restricting driving in people with seizures vary from requiring seizure-free periods of three months (which is too short for protection) to 18 months.
Having few seizure-related accidents.
Having a reliable pre-seizure warning sign, such as an aura.
Recently having reduced or changed medications.

Accidents while Swimming. Swimming poses another danger for people with epilepsy, particularly those with tonic seizures, which can cause the diaphragm to expel air quite suddenly. People with epilepsy who swim should avoid deep and cloudy water (a clear swimming pool is best), and always have with a knowledgeable, competent, and experienced companion or supervisor on site.