Safety and risk

If your seizures are controlled by treatment, your safety may not be affected. But if you continue to have seizures, safety may be an issue. Some safety issues may not be relevant to you or you may have your own ideas about what would make situations safer for you. Here are some suggestions to help you think about your safety at home.

Around the house

Alarms and safety aids

Some people with epilepsy choose to have an alarm, or monitor, to get help when they have a seizure. This can be helpful if you have seizures at night or if you live alone.  

There are different types of alarm for different types of seizure. Alarm systems may be available through local social services departments or housing associations as part of a 'needs assessment', and some alarms can be linked to a community alarm service.

Safety helmets help to protect from injury if you fall during your seizures. Some have face guards to protect, if you fall forwards.

Having a key safe installed outside your front door means others can get in to help you. See more about alarms and safety aids.

Fire safety

If you have a seizure while cooking or smoking, there is a risk of fire. The UK Fire Service recommends that everyone has a smoke alarm on each level of their home, and that the batteries are checked regularly.

Fire-resistant fabrics and furniture are recommended for everyone but will still catch fire if the heat is intense enough.

Your local fire and rescue service can provide a free safety check for your home.

Floors and furnishings

Hard flooring, such as ceramic tiles, could injure you if you fall during your seizures. Anti-slip flooring, linoleum (lino), cushioned flooring or carpets may reduce the risk of an injury. Cushioning underneath carpets, such as padded underlay, may reduce the risk of injuries further. Avoiding coarse fabrics may reduce the risk of friction burns if you have convulsive seizures.

Using protective covers on sharp edges of furniture, or having furniture with rounded edges, may avoid injury if you fall against it.

Glass

Try to avoid glass furniture, such as tables, if possible, as it can cause injury if you fall on it and it breaks.

In the UK, homes built since 1994 use safety glass for windows to reduce the risk of injuries. Safety glass is designed to be difficult to break or to hold together if it is broken.

Replacing glass in older buildings with safety glass might be helpful. Safety glass film prevents glass shattering if it gets broken. It can be fitted onto glass doors and windows, and is available from some glazing companies and online suppliers.

Heating your home

The following tips might lower the risk of injury during a seizure.

• Radiator covers may reduce injury and burns if you fall against them during a seizure.
• Using heaters that are secured to the wall or floor means you can't knock them over.
• Open fires and gas fires are best avoided.
• Covering hot pipes can prevent injury if you grip them or fall against them.

Stairs

Depending on how your seizures affect you, you may want to consider living on one level.

• Going up the stairs on your hands and feet, and coming down the stairs on your bottom may reduce risks of injury if a seizure happens.
• Some people may have the option of a toilet, bathroom or bedroom downstairs, to reduce the need for using the stairs.

Storing medication

It is best to keep medication locked away or out of reach. You can find tips on remembering to take your medication.

You may wish to use the 'message in a bottle' scheme, where you can keep all your personal and medical details, including details of your medication, on a form that you keep in a special bottle in your fridge. Bottles are usually available from GP surgeries, pharmacies or you can call the Lions Club for more information.

In the kitchen

• Microwave ovens are safer than conventional ovens as they turn off automatically after the cooking time has ended. 
• Turning saucepan handles to the side can help prevent pans being knocked off the cooker.
• Using rings or burners at the back of the hob can be safer than using those at the front.
• Induction hobs only heat up when a pan is placed onto the hob ring or plate, making them safer than gas hobs. Some cookers have an automatic switch-off feature if the hob is accidentally left on or covered by an object such as clothing. VNS devices may be affected by the magnet in an induction hob. 
• A cooker guard around the front of the hob means that the rings or burners are harder to touch by accident.
• Using a low-level grill instead of an eye-level grill can help reduce the risk of injuring your face if you have a seizure.
• Having a heat-resistant work surface means you can slide heavy pans across the work surface rather than lifting them.
• Using a cooking basket inside a saucepan means you can lift the basket out after cooking and the hot water drains back into the pan.
• Using a trolley to transfer food from the cooker to the table means that you don't have to carry hot or heavy dishes.

Making hot drinks

• Drinks can be heated in a microwave. 
• Cordless kettles that switch off automatically and have a lid that ‘locks’ shut can help prevent scalds.
• A kettle tipper (cradle) helps you to pour hot water without lifting the kettle.
• Thermal mugs with lids can help to protect you if you spill a hot drink during a seizure.

Ironing

• Using a tumble dryer may reduce the need for ironing.
• Cordless irons that switch off automatically after a set time, and have no cable to trip over, can reduce the risk of burns if you have a seizure while ironing.

In the bathroom

• Doors that open outwards or both ways can make it easier for other people to get to you if you have a seizure and need help. An alternative is a concertina door, or one that slides sideways.
• Locks that can be opened from the outside, or an 'Engaged' sign on the door instead of a lock, allows privacy but means that someone else can open the door if you need help.
• Using plastic containers for toiletries rather than glass can reduce the chances of injury if you knock them over.
• Floor tiles made of rubber or anti-slip flooring may be safer than tiled floors.

Showers

Having a shower can be safer than having a bath because the water drains away. This significantly reduces the risk of drowning. If you are choosing a new shower or changing your existing one, the following tips may help.

• Avoid showers with high-sided bases as the water level can rise if the drain is covered. Level access (walk-in) showers or wet rooms give easy access, and can reduce the number of hard surfaces to fall against, such as the side of a bath.
• A shower curtain, rather than a screen or door, might make it easier for someone to get to you quickly if you have a seizure. If there is a cubicle door, it is safer if it opens outwards.
• A shower seat may help reduce the risk of injury if you fall during a seizure.
• Soap trays set into the wall (instead of sticking out) and anti-slip shower mats can also help reduce injuries if you fall.

Baths

Having a bath carries higher risks than having a shower. If you have no shower, then the following may help to reduce risks.

• Having a bath when there is someone else around means that they can help you if you have a seizure.
• Using a listening monitor (such as a baby monitor) might make it easier for someone outside the room to hear that you are OK, while still giving you some privacy.
• Running a shallow bath and putting cold water in first can help prevent scalds.
• Fitting thermostatically controlled taps means that the water will not get too hot. 

In the bedroom

If there is a risk of you falling out of bed during a seizure, then having a low-level bed, or mattress on the floor, may reduce injuries.

Sleeping in the middle of a large bed also reduces the risk of falling out of bed during a seizure.

Padded bed sides may help prevent injuries during a seizure or stop you falling out of bed. However, these should be considered with care as it is possible for your arms or legs to become trapped or injured, depending on the design of the bed sides and how your seizures affect you.

The Medicines and Healthcare products Regulatory Agency (MHRA) advises that a risk assessment should be carried out before fitting bed sides, to make sure that they are right for your needs, and that they fit your mattress and bed safely.

Some people who have seizures during the night have a bed alarm that detects when they have a seizure. See more about alarms and safety aids or Disabled Living Foundation's information on alarms.

Safety pillows

Safety pillows have small holes in so that if you are sleeping face down you may be able to breathe more easily. However, there is no evidence that they are safer than ordinary pillows.

Gardening and DIY

If you have seizures it may be helpful to think about the type and frequency of your seizures and the potential risks of each job, and whether someone else could do it instead. Knowing your own abilities may help reduce the risks of accidents or injuries. If you are not sure about doing a job yourself, you may want to talk to a professional such as an electrician, plumber or gardener.

DIY

For anyone doing DIY, it is important to take proper safety measures. If you have seizures there may be other safety issues to consider. For example, if you need to do a job at a height using a ladder, it is important to think about the risk of falling if you have a seizure.

Power tools that have a safety cut-out and use batteries rather than mains power may be safer, as there is no power cord to damage if you have a seizure while using them. Using a circuit breaker at the socket can help protect against the risk of electrocution.

Gardening

• Grass or bark chippings are a softer alternative to concrete or gravel and may reduce the risk of a severe injury.
• Using artificial grass means that there is no need to use a lawn mower. 
• Using a petrol lawn mower means there is no chance of cutting through the cable if you have a seizure.
• Some mowers will stop automatically when the handle is released. If you do use an electric mower, a circuit breaker at the plug helps protect against electrocution. Cordless or battery mowers may be safer.

If you have a pond, here are some safety tips that may be helpful.

• Having a pond near the house can make it easier for someone to see and help you if you have a seizure and fall in.
• Having a fence around it can provide a safety barrier.
• It may be possible to fit a safety grid that sits just below the surface of the water. This can hold your weight if you fall on it, without spoiling the look of the pond.

Seizure alert dogs

Support Dogs trains dogs to support owners with specific needs including epilepsy. Seizure alert dogs are specially trained to warn their owner before a seizure starts, so they can get help or move to somewhere safe.

Training with a seizure alert dog can be intensive. To apply you would need to be having a certain number of seizures. Support Dogs are not able to train your own pet dog.

Needs assessment

You can ask your local social services for a health and social care assessment sometimes called a 'needs assessment', which looks at your safety at home. Assessments are often carried out by an occupational therapist (OT). They will visit you at home to see what help, support or safety equipment you might need because of your epilepsy. The assessment can help to identify practical ideas for reducing risk to make situations safer. Your GP or specialist may be able to provide information about how your epilepsy could affect your safety at home. You can apply directly to your local council or your GP can refer you.

Visit GOV.UK for contact details for your local council.

Out and about

Some people with epilepsy may worry about having a seizure when out and about and they may choose to wear or carry a medical identity (ID) card or medical jewellery that says they have epilepsy. Download the the card, or call our helpline for a free ID card.

Does having epilepsy put me at risk?

In all areas of our lives, we take risks, but some risks we worry about more than others. Risk is the chance of something happening such as loss or injury, and so it is often about uncertainty. Sometimes, taking a risk can mean trying something new and challenging yourself in a positive way. But, risk can also mean the chance of injury, danger, or damage to your health.

Epilepsy varies greatly from person to person, so risks due to epilepsy depend on:

• whether you currently have seizures
• the number and type of seizures you have
• how your seizures affect you, and
• whether you have other medical conditions, such as heart or breathing problems.

Possible risks to your health and safety can be difficult or frightening to think about. But looking at risks can also be positive if this helps you to find ways of reducing risk or making activities safer. It may also make you feel more in control and help you to work out what risks are relevant to your situation, so that you can see what is important for you.

People may also face specific risks because of their epilepsy, such as the risk of injury or accident. Looking at ways of managing risk may also help you do the things you enjoy and be as independent as possible while still keeping safe.

Making choices about risk

Everyone is different. You may find it helpful to look at your own situation to see what you think the risks are to you because of your seizures. Being involved in making decisions about things that affect you may help you to feel more in control of your epilepsy and confident about making decisions in the future.

Depending on your situation, you might want to include other people when making decisions, such as your parents, partner or carer and your social care or healthcare professionals. 

Activities such as swimming and cycling may be safer if you have someone with you who knows how to help if you have a seizure.

Telling people how your seizures affect you may mean they feel more confident helping you to keep safe, and know what to do if you have a seizure.

Getting good seizure control

Often the best way to reduce risks due to epilepsy, is to stop seizures from happening, or reduce the number of seizures as much as possible. For most people this is by taking anti-seizure medication (ASM) as prescribed. To work best, ASMs need to be taken every day. Using a pill box or drug wallet can help you to remember when to take your medication. 

Some medication affects how other medications work, which in turn can affect seizures. It is a good idea to check with your doctor or pharmacist before taking other medications alongside your ASM. As with any medication, ASM can have side effects. 

If you continue to have seizures even with ASM or if you are having side effects, you can talk to your doctor or neurologist about it. There may be other ASMs or doses you can try or other types of treatment may be an option.

Some people have triggers for their seizures: situations that bring on a seizure, such as stress or tiredness. If you know you have a trigger for your seizures you might be able to avoid the trigger so that you have fewer seizures.

Risk assessments

A risk assessments can help to identify practical ideas for reducing risk to make situations safer. 

You might want to do a risk assessment yourself, or it may be appropriate that a carer, an employer, an occupational health worker, or someone from social services does this with you. A risk assessment normally would include looking at how your seizures affect you, and what the environment or activity is. It might include the following:

• What are the risks to safety for anyone doing this activity?
• What is it about your epilepsy that may put you, or other people, at risk (depending on your seizure type)?
• What would make the activity safer? 

Women and risk

Some issues around risk are specific to girls and women with epilepsy. This depends on their age, type and number of seizures and any medication they are on.

Hormone levels change during puberty, periods, pregnancy and through the menopause. For some girls and women, there is a link between hormones and when they have seizures. This means that they may be more likely to have seizures, and be at greater risk of injury because of seizures, at these times.

Anti-seizure medication and risk

Pregnancy

There are specific issues around pregnancy for women with epilepsy. Women with epilepsy who take ASMs during pregnancy can have a slightly higher risk of having a baby with a birth abnormality or developmental problem than women with epilepsy who do not take ASMs. Different ASMs vary in the risk they pose.

It is important not to stop taking any ASMs without speaking to your doctor first.

The MHRA states that sodium valproate should not be prescribed to girls or women who are pregnant, or who may become pregnant in future, unless it is the only effective drug for them and they are on a pregnancy prevention programme. This risk needs to be balanced with the risk of injury to the mother and baby if seizures are not controlled with medication. In rare cases, risks of uncontrolled seizures can mean very serious injury, or even death.

Because these issues are often complicated and specific to each woman, it is important that women talk to their epilepsy specialist before becoming pregnant. This is called 'preconception counselling' and focuses on making sure ASM treatment is right, for the mother to get the best seizure control, and for the baby.

Risks for men

Due to concerns about the link between sodium valproate and the risk of impaired male fertility, from January 2024 men under the age of 55 should not be started on sodium valproate.

If possible, men who take sodium valproate should change to another ASM unless two specialists decide that there is no other effective treatment or the risks do not apply.

These changes follow a review of safety information relating to sodium valproate. 

Can seizures damage the brain?

Everyone has some brain cell loss as they get older. Whether seizures cause any extra loss of brain cells is not clear. This may depend on the type and length of seizure that the person has.

Memory can be affected during or after a seizure. This can be because brain cells in parts of the brain responsible for memory can be sensitive to the effect of seizures. If you are worried about this, you might like to talk to your neurologist or doctor about how your epilepsy might affect you.

How serious can risks be?

For some people there is a risk of dying due to their epilepsy. In the UK there are around 1200 deaths related to epilepsy a year. Some of these deaths are caused by complications during or after a seizure. Other deaths may be due to accidents such as falls, or drowning, suicide, or they may be linked to another condition that a person may have alongside their epilepsy. 

What is status epilepticus?

Usually a seizure will stop by itself. Sometimes this does not happen and a seizure is very long or one seizure happens after another without the person recovering in between. If this carries on for 5 minutes or more, it is called status epilepticus (or 'status').

If status happens in a tonic clonic seizure (where people fall down and shake), this is a medical emergency and an ambulance needs to be called immediately. Emergency medication may need to be given to stop the seizure. If a tonic clonic seizure goes on for 30 minutes or more, this could cause lasting damage to the brain, or even death.

What is SUDEP?

On rare occasions people die suddenly for no clear reason. When this happens to someone with epilepsy it may be called Sudden Unexpected Death in Epilepsy (or SUDEP). SUDEP is when a person with epilepsy dies suddenly and where no other cause of death is found.

Mental wellbeing

If you are concerned about anything you have read on this page, it is worth remembering that not all of the risks may apply to you and they may depend on the type and number of seizures you have and how they affect you. 

Many people with epilepsy enjoy a full and active life. But for some, epilepsy may come alongside anxiety, stress, or depression. Everyone is different in how they cope with anxiety or depression, but this may increase the risk of long term problems or even suicide. If you feel that your epilepsy affects your mental wellbeing or quality of life, you may be able to get support through your GP, a counsellor, an epilepsy specialist nurse, or a helpline. 

If you would like to talk to someone in confidence about what you have read, you can call our helpline. 

Epilepsy Society is grateful to Dr Fergus Rugg-Gunn, Consultant Neurologist, Epilepsy Society for his guidance on this information.

Further information

• Disabled Living Foundation provides information on alarms, living aids, safety products and suppliers.
• RiDC carries out product reviews on safety aids and equipment.

Please note: Epilepsy Society does not endorse any suppliers of safety aids or equipment. Other companies may also provide these products.

Information updated: February 2024