Dr.Prithika Chary
Senior Consultant Neurologist, Neurosurgeon & Epileptologist
Chennai
People with epilepsy often have concerns about employment. They worry about getting a job suitable to their skills, and fear prejudice and marginalization from colleagues and employers. The truth is that very few jobs are barred for people with epilepsy. Countries like the UK have the Disability Discrimination Act and the USA has the Americans with Disabilities Act which protect people being discriminated on the grounds of epilepsy.
Like for everyone else, job availability and employability depends on skills, expertise and experience. Sometimes people with epilepsy have been so sheltered and protected they do not acquire job skills and expect to be given privileges just because they suffer from epilepsy. Epilepsy is not an excuse for not obtaining the appropriate educational qualification or skill training. If seizures are well controlled on medication or if seizures only occur in sleep or at night the job prospects of a person with epilepsy are higher.
People with epilepsy are not allowed to work in the Armed Forces. For health and safety reasons jobs involving working at heights, near or in open water bodies like diving,etc, or driving eg train, car, lorry drivers, working near or with high voltage electricity, unguarded fires, etc are not suitable jobs for people with epilepsy. Some other jobs involving caring for babies or children ( nurses, midwives, primary school teachers ) or handling fragile objects may also not be suitable. Jobs entailing frequent travel across time zones are also troublesome as the sleep deprivation can aggravate seizures.
In effect, most other jobs besides those mentioned above are okay for people with epilepsy.
It is unrealistic to give the impression that epilepsy does not pose a problem with employment. For instance, working with computers has became part of all jobs in today’s world. Prolonged computer usage can trigger seizures, especially in those with photosensitive epilepsy, which occurs only in 1 in 10,000 of the population. However,even if a person does have photosensitive epilepsy, this does not automatically mean they will have a seizure when using a monitor. They just have to follow the 20-20-20 rule which also helps computer vision syndrome in normal people. Every 20 minutes they take their eye of the screen for 20 seconds and look at something 20 feet away.
Photosensitive epilepsy is the name given to a form of epilepsy in which seizures are triggered by flickering or flashing light.
Both natural and artificial light sources can cause flickering which might be a problem for people with photosensitive epilepsy.
Most people with photosensitive epilepsy are sensitive to flickering around 16-25Hz, although some people may be sensitive to rates as low as 3Hz and as high as 60Hz.
People with photosensitive epilepsy usually develop the condition before the age of 20, with it being most common between the ages of nine and 15. More females than males seem to have photosensitive epilepsy. There is also evidence of a genetic factor in this condition.
Photosensitive epilepsy is most often easily treated with the antiepileptic drug Sodium valproate.
They most certainly can, if they follow some precautions which are healthy for even those without epilepsy to follow and adopt. The refresh rate for most TVs and Monitors is 50-60 Hz though now 100Hz VDUs are available. Sitting too close to the screen can aggravate seizures. A smaller screen 12-14 inches with a stable picture with a dim picture in a moderately lit room is preferable, especially when dealing with flashing graphics as in a videeogame. Colour content of the picture may be important, red being more seizurogenic than blue. Moving striped patterns are seizurogenic.
Often, the problem with epilepsy is one of physical danger rather than misunderstanding or lack of knowledge from others. Most people are usually very willing to help and make allowances if they understand something about epilepsy and know how to react.
It is both useful and a good way of creating understanding to tell other employees what happens during a seizure, and to explain what to do and what not to during an attack. It is also a good idea for someone with first aid experience to be available, so that skilled help can be given if it is needed.
First, it must be said that most people with epilepsy may never have a seizure at work. But if it does happen, common sense is generally a good guide on how to react. When a major convulsive (tonic-clonic) seizure occurs, see that the person is lying in a safe position and place something soft, such as a cushion or rolled up sweater, under the head. Clothing around the neck should be loosened, if possible. Liquids should not be offered. No object, hard or soft, should be inserted into the mouth, because of the risk of broken teeth or obstructed breathing. Do not attempt to restrain involuntary movements during a major attack. Once the seizure has finished, place the person in the recovery position – turn the head to the side and the body slightly to the side as well
There is generally no need to call for medical assistance unless there is injury of some sort, or unless the seizure shows no sign of stopping after five minutes, or one seizure follows another without the person recovering consciousness in between attacks. The majority of seizures, however, last for a few seconds or minutes.
In the UK disabled and nondisabled people are included together in employer’s liability insurance policies. Hence no special insurance cover is needed. With multinational insurance companies offering mediclaim policies epilepsy is covered by some of them.
It is therefore evident that epilepsy is not a contraindication for employment. In fact, several studies have demonstrated that people with epilepsy work well, have an excellent attendance record, do not stress the medical benefit allowance (except that the organizations support may be needed for ensuring regular anticonvulsant medication ) and in between seizures can be as normal as anyone else.