E-360 Edition 13: A Guide to Safety

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Just imagine, one minute you are carrying out your usual daily activities, and then next, you are temporarily unaware of anything happening around you. It’s hard to imagine but this is what many people with epilepsy have to live with. Depending on what you are doing or where you are, this loss of awareness can pose significant risks to safety, particularly if falls are also associated with seizures.

Seizures, medications, and even other health conditions bear potential risks for many people. So if you have seizures it’s worth thinking about any risks that may potentially arise. Learning to lessen risks is a critical part of living safely with seizures.

Here we will discuss a few common safety concerns for people who have seizures.

Driving

Seizures causing loss of awareness (even if brief) or loss of motor control can impair one’s ability to control a vehicle. Clearly this is dangerous and it is your responsibility to not drive until it is considered safe to do so.

Anyone who has a seizure will be informed not to drive for a specified period. This period depends on many things including; the cause of the seizure, the type of seizure you had, if it is epilepsy, and what type of epilepsy. Typically people need to be seizure free for a period of time, ranging from 3 to 12 months depending on the situation.

There are standard guidelines followed in Australia which is explained in Assessing Fitness to Drive http://www.austroads.com.au/drivers-vehicles/assessing-fitness-to-drive

It is important to remember that if or once you have met certain criteria you will be able to drive again – safely and legally. Unfortunately, not everyone will get their licence renewed, and others may be issued a conditional licence. Ultimately the decision to suspend or renew a driver’s licence rests with the Drivers Licensing Authority (DLA) not the doctor.

Even if you have seizure control, you must not drive during periods of antiepileptic medication reduction, withdrawal or changes because there is an increased risk of seizures with medication changes.

Your responsibilities

  • Legally, you must notify the DLA in your state or territory if you have a blackout, seizure, epilepsy or are diagnosed with epilepsy.
  • You are responsible for making sure that you are taking medication as prescribed.
  • You should avoid circumstances and triggers that are known to increase the risk of your seizures.
  • Do not drive if you are having seizures or side effects that affect your ability to be safe on the road.
  • Be honest with your doctor about your seizures. Safety comes first.
  • If you have a conditional licence you need to comply with driving restrictions set out.
  • If you are planning any reduction, withdrawal or change of antiepileptic medication, you must not drive for this period or a period specified by your doctor.
  • It is good practice to have regular reviews with your doctor.
  • Be honest with the DLA. It may protect you legally if problems occur later.

Around Home

Injuries and accidents probably occur more around the home than anywhere else. There are many ways you can make your home safer. Try doing a few things like:

  • Arrange your home and if possible other areas such as work or study space, to be safe in the event you have a seizure.
    • For example, pad any sharp corners, use non-slip flooring, always have good barriers in front of fireplaces or heaters, and it is recommended you have a door that opens both ways into your bathroom/toilet.
  • If you wander or are confused during or after a seizure.
    • Pay special attention to heights, railings, stairs and swimming pools or even fish ponds.
    • Shut your door when you are home alone, so you are less likely to wander outside or into dangerous areas.
    • Make sure someone else has a key to get in and check on you.
    • Consider wearing some form of medical ID
  • If you are likely to fall during seizures, “fall-proof” your home and other areas as much as possible. Put in carpets, cover sharp corners, and avoid glass tables and shower screens.
  • Some people with frequent falls may need to consider wearing a protective helmet.

See our Seizure Safety Factsheet (https://www.epilepsy.org.au/wp-content/uploads/2017/08/Fact-Sheet-Safety.pdf) for more suggestions.

Sports and physical activities

Most sports and activities are safe for people with epilepsy to take part in. In fact, physical exercise and playing sports can have positive effects for people with epilepsy such as improved seizure control, as well as broader health and psychosocial benefits.

Exercise rarely triggers seizures. Only about 2% of people with epilepsy have genuine exercise-induced seizures, and regular physical exercise may have a moderate preventive effect on seizures in 30-40% of people with epilepsy.

Sometimes seizures may happen in relation to the immediate effects of exercise. Some possible explanations for exercise triggering seizures include:

  • Low blood sugar
  • Dehydration – sweating profusely during exercise and not rehydrating
  • Becoming overheated or overtired
  • Over breathing (hyperventilation)
  • Changes in medication levels – due to metabolic changes

So use your common sense when choosing a sport or activity and when playing it. Don’t overdo it and keep yourself hydrated. Use protective head gear with contact sports. Also make sure there is at least one person present who knows you have seizures and what to do if one happens.

If a seizure during any recreational activity could lead to injury or harm, have a plan and take safety precautions with that activity. It all depends on individual circumstances, so talk with your doctor or epilepsy nurse for further guidance.

There are no hard and fast rules. Each person must decide what the risks are for each activity and make a conscious decision about whether to take those risks. Also bear in mind the safety of others if you have a seizure during some activities.

Develop a Safety Plan

  • Plan ahead for what you and your family or friends should do if a seizure happens. Think about situations that may occur and create a seizure management plan (https://www.epilepsy.org.au/how-we-can-help/our-services/seizure-management-planning/)  including any possible scenarios so others know what to do if you have a seizure and how to prevent emergencies.
  • So think through situations such as if a seizure happens:
    • If you are alone
    • In a public place with strangers
    • In an environment that is potentially dangerous such as in water, a moving vehicle or public transport, or sports field
    • When you are asleep
  • If you have a seizure or are not able to talk for yourself, you want other people to know who you are, what to do and who to call. This may depend upon the types of seizures you have and how long they last.
  • Make sure people close to you know seizure first aid (https://www.epilepsy.org.au/about-epilepsy/first-aid/ ) as this helps them feel more confident if they need to help out
  • Will an ambulance need to be called?
  • Is there anyone they can contact for you?

General safety measures

People have different experiences.

  • Some people have enough warning that their seizures are going to occur to get themselves to a safe place,
  • Some people have identifiable seizure patterns for example, seizures only happen first thing in the morning. This usually means there is more predictability and gives more flexibility to work around safety issues.
  • Some women have seizures directly associated with menstruation, so take more precautions at this time.

Not everyone has to follow strict safety measures, and it is all relative to your situation. Do not put restrictions on yourself that reduces your quality of life or the things you enjoy.

One of the most hazardous aspects of a seizure is your risk of falling down. Many falls result in just a few bumps and bruises, but some can be much worse. Since it’s hard to prevent falls during seizures, it’s important to make the areas around you as safe as possible. Even if you don’t have a history of falling down during seizures, you might fall one day. Safeguarding your home and planning what to do if a seizure happens in public, can help keep you safe.

There are a number of products and alarms on the market to improve safety for people with epilepsy and ease anxiety for parents or carers.