Keeping people with epilepsy safe during the Covid-19 pandemic

An international group of epilepsy specialists from around the world, including Professor Ley Sander, Medical Director at the Epilepsy Society, have drawn up new recommendations for helping to keep people with epilepsy safe during the covid-19 pandemic.

Keeping people with epilepsy safe during the Covid-19 pandemic, published in the journal Neurology, sets out to help healthcare professionals provide the best possible care for people with epilepsy while avoiding visits to care facilities and hospitals.

The specialists stress that people with epilepsy are at no greater risk of Covid-19 unless they have an additional risk factor such as old age, immobility, respiratory disease, severe heart disease, diabetes melitus, hypertension and immunosuppression. However, they advise those with the condition to remain isolated from contacts and symptomatic individuals where possible.

Emergency medication for those with well controlled epilepsy

They stress the importance of minimising risk of seizures through medication adherence – ensuring that medication is taken regularly, as prescribed – and ensuring a regular supply of epilepsy drugs.

They also recommend, that during the pandemic, even those people with well controlled epilepsy should have an emergency care plan in place and should be prescribed rescue medication for an emergency. Individuals and their families/carers should be given clear instructions on how and when these should be used, and when it might be necessary to attend an emergency department.

Appointments should be carried out through telehealth videos and phone calls to avoid visits to hospital and surgery settings.

Looking after people with epilepsy

According to the recommendations for caring for people with epilepsy, healthcare professionals should:

• Discuss best ways to minimize the risk of seizures (for example, good medication adherence, plenty of sleep, regular meals, avoiding known seizure triggers)
• Consider a ‘comprehensive care plan’, with information about what should happen if families/caregivers are ill or not available.
• Emphasise the importance of adherence and  maintaining routines such as use of pillboxes, cell phone alarms or phone apps. This is particularly important if the individual with epilepsy is separated from their usual caregivers/family member, who may be ill and were helping to administer medication
• Instructions should be given to maintain a regular medication supply. People with epilepsy and their families/carers should work to prevent medication shortages and ensure that repeat prescriptions are available. Consideration should be given to obtaining medication through online pharmacies, where feasible.
• General advice should be given to ensure adequate sleep where possible, engage in routine exercise, healthy eating, and avoidance of alcohol and recreational drugs, where appropriate. For those with stimulus-induced ‘reflex’ epilepsies (eg photosensitive epilepsy), discussion of reducing or eliminating provocative stimuli (eg computer games) may be necessary
• Where people require emotional support, such as for anxiety and depression, they should be directed to helplines such as Epilepsy Society’s Helpline 01494 601400.

You can read the full recommendations at Neurology.