There can be a lot of misunderstanding about epilepsy and seizures, but it is a common condition. About one in a hundred people has epilepsy, so you may already know people with the condition. This page aims to help you learn more about epilepsy, to understand how it might affect you, and answer some questions you might have about living with the condition.
People respond to a diagnosis of epilepsy in different ways, and it can take time to get used to. For some people it’s a relief, especially if they have been waiting for a diagnosis for a long time. For others, it may be a shock. It can be a difficult time, with many challenges. You might experience lots of different, and changing, emotions.
Giving yourself time to work out how your epilepsy affects you and what choices to make, can be helpful. Although some people want information and support straight away, others want to wait for a while until they feel ready to start finding out more. Our confidential helpline is available when you feel you are ready.
What is epilepsy?
Anyone can develop epilepsy, at any time of their life. Epilepsy is not just one condition, but a group of many different ‘epilepsies’ with one thing in common: a tendency to have seizures which start in the brain. Epilepsy is a neurological condition, which means it affects the brain and the nervous system.
Epileptic seizures are usually sudden, last a short time, and stop by themselves. They can start when you are awake or asleep and can cause a change in awareness of what you are doing, your behaviour, or your feelings. There are many different types of seizure and the type of seizure you have depends on which part of your brain is affected and what that part of your brain controls.
Epilepsy is not just one condition, but a group of many different 'epilepsies' with one thing in common: a tendency to have seizures that start in the brain.
There are many different types of epileptic seizure. Any of us could potentially have a single epileptic seizure at some point in our lives. This is not the same as having epilepsy, which is a tendency to have seizures that start in the brain.
There are a number of common misconceptions surrounding epilepsy and epilepsy terminology.
What triggers seizures?
For some people certain situations can ‘trigger’ a seizure (make a seizure more likely to happen). Triggers are not the same as underlying causes, and can vary but include lack of sleep, stress, excitement, alcohol, and not taking your medication as prescribed. Flashing or flickering lights or certain visual patterns can be a trigger for some people with epilepsy, but this is rare.
Having a good night's sleep helps our brains to recover from the day's events, so that we can function well the next day. For some people with epilepsy a lack of sleep can make seizures more likely to happen, for others having seizures at night can make them feel tired during the day.
For some people, stress can be a trigger for their seizures and for others just having epilepsy can be stressful. Here we look at the links between stress and epilepsy.
Whether to drink alcohol or take recreational drugs is a personal choice, but it is worth knowing the possible effects they could have on your epilepsy. Alcohol or recreational drugs can cause epilepsy in some people.
Who will I see about my epilepsy?
During your diagnosis you will probably have seen a neurologist. Some neurologists specialise in epilepsy. It is the neurologist who will generally diagnose epilepsy and prescribe and start any treatment, such as medication.
You might continue to see a neurologist while trying to get your seizures controlled, and you could also have ongoing regular reviews of your epilepsy with a neurologist. NICE (the National Institute for Health and Care Excellence) produces guidelines, and recommends that anyone who has a seizure is seen urgently (within two weeks). This is with a specialist to make a diagnosis and discuss treatment.
Epilepsy specialist nurse (ESN)
You might see an epilepsy specialist nurse (ESN), who can be a good link between you, the neurologist, and your GP. Specialist nurses might be involved in your treatment, and they may support you in other ways, such as talking to you about your epilepsy and how you are getting on.
General Practitioner (GP)
Your GP might also be involved in your epilepsy management. They are usually responsible for prescribing any ongoing treatment, and they are generally the first person you go to if you have any questions or concerns. Some GPs have a specialist interest in epilepsy.
You might also see other people about your epilepsy, depending on how things are for you. This could include an occupational therapist, community nurse, or social worker.
What treatment options are there?
Epilepsy is sometimes referred to as a long-term condition, as people often live with it for many years or for life. Although generally, epilepsy cannot be ‘cured’, for most people, seizures can be ‘controlled’ (stopped), so that epilepsy has little or no impact on their lives. So treatment is often about managing seizures in the long-term.
Most people with epilepsy take anti-seizure medication (ASM) to stop their seizures from happening. However, there are other treatment options for people whose seizures are not controlled by ASM.
Vagus nerve stimulation therapy is a treatment for epilepsy that involves a stimulator (or 'pulse generator') which is connected, inside the body, to the left vagus nerve in the neck. The stimulator sends regular, mild electrical stimulations through this nerve to help calm down the irregular electrical brain activity that leads to seizures.
Brain surgery or neurosurgery is one way of treating epilepsy. Certain criteria have to be met and tests have to be done to assess suitability.
The ketogenic diet is one treatment option for children or adults with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and may have other positive effects.
Issues for women and girls
For some women and girls with epilepsy, hormone level changes affect when their epilepsy starts, how often seizures happen, and whether their epilepsy goes away. Hormone levels change during puberty, through the menstrual cycle, during pregnancy, and during the menopause.
Some types of contraception can be affected by ASM, making it less effective in preventing pregnancy. Talking this through with your doctor is important to help you decide on the right contraception for you. If you are thinking of starting a family, it is essential to talk to your neurologist about your epilepsy treatment for your pregnancy and for when your baby arrives.
Getting specialist advice, or preconception counselling, before you become pregnant can help to keep you and your baby safe. Although the vast majority of women with epilepsy will have a healthy baby, some ASM can affect the development of an unborn baby. Risks depend on the type of ASM prescribed, the dose, and each individual situation, and they need to be balanced with seizure control. These issues will be considered when deciding whether to start treatment, and what treatment would be suitable.
The Medicines and Healthcare products Regulatory Agency (MHRA) have announced some important changes to the way that the ASM sodium valproate is prescribed. These will affect both men and women under the age of 55 and girls of childbearing age. Find out more.
If you start taking ASM, your neurologist should plan for the possibility of you taking ASM long-term, even if you are not thinking about becoming pregnant at the moment.
Some issues around epilepsy and its treatment are specific to women and girls and do not apply in the same way to men. These include links between epilepsy and hormones, puberty, contraception, pregnancy and the menopause.
Most women with epilepsy do not have any change in their seizure frequency during pregnancy. However you might find that your seizures are better controlled during pregnancy, or that you have more seizures than is usual for you.
Sodium valproate is an epilepsy drug prescribed for all seizure types including absence, myoclonus and tonic clonic seizures. New regulations have been introduced by the Medicines and Healthcare products Regulatory Agency (MHRA) around the way in which the drug, sodium valproate is prescribed to women and girls of childbearing age.
How can I manage my epilepsy?
Taking an active role in managing your epilepsy (‘self-management’) can be an important part of helping to reduce your seizures and feeling in control. Learning about how your epilepsy affects you, and being involved and able to make informed choices about managing your treatment, is all part of this. Having a good relationship with your healthcare professionals and your pharmacist can also help.
Some people choose to keep a diary of when their seizures happen, any triggers, any side effects, and how they feel.
Improving your overall wellbeing may also help to reduce the number of seizures you have. This could include having a balanced diet, keeping physically active, sleeping well, and finding ways to relax and manage any stress. Some people find complementary or psychological therapies help with their overall wellbeing. For some, just talking to someone who understands can help too.
A balanced diet from different food groups helps the body and brain to function, helping us to stay healthy. This may help reduce the risk of seizures for some people with epilepsy.
How exercise can help your overall health and wellbeing, and how this may also help your epilepsy.
How complementary therapies can help to promote your wellbeing and underlying health as well as reduce your stress levels.
Will my epilepsy go away?
Many people need to take ASM, or other treatment, long-term to keep their seizures under control. However, for some people, their epilepsy goes into ‘spontaneous remission’ and seizures stop happening. This can depend on the underlying cause of seizures. If this happens for you, you and your specialist may decide together to gradually stop your treatment, and they can help you do this safely.
Does epilepsy affect my safety?
Keeping safe while having a full life, can be about balancing what is most important to you with what will keep you safe. If your seizures become controlled, your epilepsy may have little effect on what you do. Some activities, including some sport and leisure activities, carry more risk of accidents or injury if you have seizures. But they may be made safer with simple measures and by thinking about how your seizures affect you.
If during your seizures you become confused or do things that you don’t remember, you may want to think about what would help to keep you safe. Some people get a warning (when they know a seizure is going to happen) which may give them enough time to get to a safe place before a seizure happens.
Risks of injury are not always easy to avoid, and can be worrying to think about. But being aware of risks, and how you might be able to reduce them, might help you feel more in control of your epilepsy. Although seizures are usually short (a few seconds or minutes) and stop on their own, for some people seizures do not stop. This is called Status Epilepticus (Status) and the person might need emergency medical help to stop them.
For a small number of people, there is a risk of dying due to seizures (sometimes called SUDEP or sudden unexpected death in epilepsy).This can be frightening to read about but it is rare. A key way to reduce risks is to prevent seizures from happening, by taking your ASM as prescribed and having regular reviews. It can also be important to stay healthy, and avoid, where possible, any known trigger for you.
Risks due to epilepsy depend on what someone's epilepsy is like. Getting good seizure control and staying safe are ways to help reduce risks.
Sometimes a person with epilepsy dies during or following a seizure for no obvious reason. This Sudden Unexpected Death in Epilepsy (SUDEP) is uncommon and in some cases may be preventable.
Can I drive if I have epilepsy?
If you have a driving licence and you have a seizure, the DVLA regulations say that you must stop driving. For many people this can have a big impact and can be very difficult or upsetting. By law you are responsible for telling the DVLA about your epilepsy and returning your licence to them. This is the case whatever type of seizure you have had, whether you lost consciousness or not, and whether or not you are taking ASM.
If you can’t drive due to your epilepsy, you can get free or discounted travel on buses, trains, and tube. If you can’t get to work using public transport, you may be able to get financial help through the Access to Work Scheme.
If you drive, one immediate effect of having a seizure is that you have to stop driving. This is true for all types of seizures, and whether you have a diagnosis of epilepsy or not. For many people, this can have a big impact on their life and can also be difficult and upsetting.
When you can drive depends on the type of seizures you have now, the type of seizures you have had previously, and what type of licence you have.
This information is for people who have epilepsy and covers Group 1 (cars and motorbikes) and Group 2 (buses, coaches and lorries) licences.
Can epilepsy affect my work?
Whether epilepsy will affect your work depends on how your epilepsy affects you and what your job involves. For example, jobs which involve driving, working with machinery, near open water, or at heights, could be affected. Although you do not legally have to tell an employer about your epilepsy, it may be important for them to know so that they can keep you safe at work and treat you fairly.
To keep you and other employees safe at work, your employer might need to do a risk assessment of your work environment and the tasks involved in your job.
Whether or not you work, you may be entitled to claim benefits or other financial help. This will depend on how your epilepsy affects you and your financial situation.
Epilepsy is sometimes classed as a disability. While some people find the term ‘disability’ negative or a ‘label’ that doesn’t feel right, it can be useful to know what this term means and how it might help you to find support. The Equality Act 2010 is a law that aims to ensure that people are treated fairly and are not discriminated against. This applies to employment, education, and accessing services (such as using shops, health or leisure services). Groups specifically covered by the act include people with disabilities.
Epilepsy is considered a disability when it greatly affects someone’s ability to do everyday activities (such as concentrating or remembering things), over a long period.
Epilepsy is sometimes described as a hidden disability because it is not always obvious that someone has epilepsy unless they have a seizure.
Whether you feel that you have a disability or not, you are protected by the Equality Act if your epilepsy affects you in this way. Depending on how your epilepsy affects you, there may be help available, such as benefits or support at home.
Having epilepsy does not necessarily stop someone from doing the job they want, but there are some issues which can affect them at work. Whether someone’s epilepsy affects their work depends on whether they have seizures, what their seizures are like and how often these happen.
Having epilepsy does not automatically entitle you to claim benefits. These are some of the benefits you may be eligible to apply for, depending on how your epilepsy affects you, and your financial situation.
The Equality Act 2010 came into effect in October 2010. It replaced nine previous laws that aimed to protect people against discrimination, including the Disability Discrimination Act 1995 (DDA).
Developing epilepsy in later life
There are many causes of epilepsy but some are more common in later life. As we age, the blood vessels that supply blood to the brain may become narrower and harder, which can affect the flow of blood, and therefore oxygen, to the brain.
The most common cause of seizures starting in later life are cerebrovascular, where there are changes or damage to the blood vessels around the brain. Some people who have had a stroke may have one or more seizures. However, this does not necessarily happen, and, often, seizures are not linked with strokes.
There are many possible causes for developing epilepsy in later life. An important part of investigating epilepsy involves checking for other conditions that may look like epileptic seizures.
Connecting with others
Many people who contact us say that having someone to talk to, who either has epilepsy, or knows about it, can be really helpful. For some, it can be an important part of coming to terms with a diagnosis of epilepsy.
You might already have people around you who can help and support you. If you would like to, there are various ways in which you can make contact with other people.
Some people find face-to-face support through meeting other people with epilepsy helpful. You could ask your GP or hospital if they know of any support groups locally.
Epilepsy Society Helpline
Our confidential helpline can talk to you about epilepsy and how you are feeling. You can talk things through and think about what you want to do.