Wearing a face mask with epilepsy
Wearing a face covering or mask is to become mandatory in shops in England from 24 July 2020. It is already mandatory on public transport. So what does this mean for people with epilepsy?
If your seizures are well controlled, then the advice for you to stay safe will be the same as for those who do not have epilepsy. The Covid-19 pandemic has not gone away and therefore it is still important to observe the Government’s social distancing guidelines, staying 2m apart from others wherever possible, and 1m where this is not possible.
And, under the new guidance, you must wear a face covering or mask where closer contact cannot be avoided, such as on public transport or in a supermarket.
A face covering is not the same as the surgical masks or respirators used by healthcare professionals. These should be preserved for those who require them in their place of work. A cloth face covering is recommended by the CDC.
Ongoing seizures and face masks
For people with ongoing seizures, there can be a few more considerations and it is important to look at your own individual circumstances and risks, and what you think will work best for you, while staying safe.
The following are some broad guidelines to help you consider how best to stay safe:
- If you have uncontrolled seizures and are going to a public place where you cannot guarantee social distancing, you should wear a mask. Try not to wear the mask for long periods of time, but take short breaks in a safe location where you are not in close contact with others. If possible, go out with a member of your household or bubble who would be able to assist you if you have a seizure. Your friend or family member would be able to remove your mask in the event of a seizure.
- If you are walking or exercising in a public place and are not likely to come into close contact with others, wearing a mask should not be necessary. If you think there is a risk you might have a seizure, it is advisable to ask a member of your household or bubble to go with you, so that they can assist you.
- If you think that wearing a mask will make you feel anxious or claustrophobic and this might in itself trigger a seizure, then you may prefer to stay at home and ask a friend or volunteer to go to the shops or pharmacy for you.
- At all times when you are wearing a mask, try to take intermittent breaks, removing the mask in a safe location.
- We would hope that even in these challenging times, a member of the public would stay with someone who is having a seizure, keeping a safe distance while they call for an ambulance. Where possible, it is helpful to remove a person’s mask if they are having a seizure or are in the recovery stage. This will facilitate their breathing. However, it is important for the person assisting to safeguard themselves from potential harm, through precautionary measures such as hand washing.
- If a person is in need of emergency medication such as buccal midazolam, their face mask should of course be removed, again following appropriate precautionary measures.
What is the evidence around wearing a mask for people with epilepsy?
A new report published by an international group of epilepsy experts, including Professor Helen Cross*, has looked at the safety issues around wearing masks for people with epilepsy.
The report 'Is wearing a face mask safe for people with epilepsy?' finds that, while there is no concrete evidence, wearing a mask may simulate hyperventilation for some people, which in turn may provoke a seizure. However, in the absence of any treatment or vaccine for Covid-19, prevention remains the best strategy and masks are most likely to be effective in helping to prevent the spread of the disease.
The authors therefore recommend that people with epilepsy only wear masks in crowded spaces where social distancing is not possible (supermarkets, shops, theatres, theme parks). They also suggest removing the mask for intermittent breaks in a safe location.
Masks should not be worn when undertaking extensive physical exercise such as walking or jogging.
What is the evidence around removing a face mask from someone who is having a seizure?
The report says it should be considered reasonable to remove a mask from someone who is having a seizure or recovering from a seizure. This will help to facilitate their breathing.
However, at all times, precautionary measures, including thorough hand washing, should be taken by the person who is assisting, in order to protect them from exposure to potential harm.
* Professor Helen Cross is the Prince of Wales's chair of Childhood Epilepsy and Head of the Developmental Neuroscience Programme at UCL-Great Ormond Street Hospital Institute of Child Health.
You can read the full report, 'Is wearing a face mask safe for people with epilepsy?' here.