Safety and risk

If you have a seizure while cooking, smoking or vaping, 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 fire safety check for your home. 

Some types of hard flooring, such as ceramic tiles, could injure you if you fall on them.

• Anti-slip flooring, linoleum (lino), cushioned flooring, or carpet may reduce the risk of an injury if you fall.
• Cushioning underneath carpets, such as padded underlay, may reduce the risk of injuries further. 
• Keeping floors clear of clutter may help. 
• Avoiding coarse fabrics may help to reduce the risk of friction burns if you have seizures where you shake or jerk.
• Using protective corners on sharp edges of furniture, or having furniture with rounded edges, may reduce injury if you fall against it.
   

• 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.

• 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.

• Depending on how your seizures affect you, you may want to consider living on one level. Some people may have the option of a toilet, bathroom, or bedroom downstairs, to reduce the need for using the stairs. 
• 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.
   

• It is best to keep medication locked away or out of reach.
• The ‘message in a bottle’ scheme, allows you to keep personal and medical details in a special bottle in your fridge. Bottles are available from GP surgeries, pharmacies, or from the Lions Club.        

• Microwave ovens are safer than conventional ovens as they turn off automatically after the cooking time has ended. This means there is less chance of food burning or a fire starting if you leave it unattended. The outside of a microwave may stay cool, so it is less likely than an oven to cause burns if touched. 
• Modern air fryers come with safety features such as auto shut-off, overheat protection, and cool-touch exteriors to make cooking safer. 
• Turning pan 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. 
• A cooker guard around the front of the hob means that rings or burners are harder to touch by accident. This may reduce the risk of burns if you lose some awareness during your seizures. However, if you fall during a seizure, a cooker guard could cause injury if you fall onto it, depending on the design. 
• Using a low-level grill instead of an eye-level grill can help to reduce the risk of injuring your face if you have a seizure. 
• Having a heat resistant work surface means that you may be able to slide heavy pans across it rather than lifting them. 
• Using a cooking basket inside a pan 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 oven to the table means that you don’t have to carry hot or heavy dishes.

• 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. 
• Drinks can be heated in a microwave. Stirring the drink will prevent any uneven ‘hot spots’ which could burn your mouth.
   

• 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.

• 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.

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.

• 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.
• Avoid showers with high-sided bases as the water level can rise if the drain is covered. 
• 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.

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. 

For more information visit livingmadeeasy.org.uk or ridc.org.uk

• 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 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.

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.

• Grass or bark chippings are a softer alternative to concrete or gravel and may reduce the risk of a severe injury if you fall.
• 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, 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.

Everyone is different. 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 others when making decisions, such as your parents, partner, or carer, and your health or social care 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.

Often the best way to reduce risks due to epilepsy is to stop seizures 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, ASM needs to be taken every day. Using a pill box or drug wallet can help you to remember when to take your ASM. 
Some medication affects how other medications work, which 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. Possible side effects include tiredness, confusion, and changes in mood. For some people, these side effects mean that they don’t want to continue taking their ASM. But suddenly stopping ASM can cause seizures to happen again.

If you still have seizures, even with ASM, or you are having side effects, talk to your doctor, pharmacist, or neurologist. 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 you might be able to avoid it so that you have fewer seizures.

Risk assessments may be useful at work or school, for leisure activities, or for ways to make your home safer. You might want to assess risks for yourself, or it may be appropriate that a carer, employer, occupational therapist, or someone from social services does this with you.

A risk assessment normally includes looking at whether you have seizures or not, how your seizures affect you, and what the environment or activity is. 

A risk assessment might include:

• 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?
• What would make the activity safer? 

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

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

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

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.

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 under the age of 55, 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.

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 a specialist decides 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. 

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.

An ambulance should be called if:

• it is the person’s first seizure; 
• they have injured themselves badly; 
• they have trouble breathing after the seizure;one seizure immediately follows another with no recovery in between;
• the seizure lasts two minutes longer than is usual for them; or 
• you do not know how long their seizures last. 

For more, see our information on first-aid and the recovery-position.

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. It may be that they died during or after a seizure.