Epilepsy – Social and Cognitive Considerations

Epilepsy is a neurological disorder that affects up to 2% of the population. Different neurologists have different criteria for diagnosing someone with epilepsy; some diagnose with as few as two seizures and others wait until there seems to be a clear pattern of seizures. There is also considerable heterogeneity in seizure activity, which makes diagnosis difficult. Once diagnosed, a person will never completely be free from or cured of the diagnosis of epilepsy. People are not free from epilepsy, they are called in partial or full remission if their seizures are well-controlled. Medications and surgery are effective at controlling seizures but they do not always work. If epilepsy is uncontrolled or uncontrollable then people with the disorder are prohibited by law from operating motor vehicles. This makes a lot of sense because seizures can occur at any time which could result in serious injury or death of the person with epilepsy or of others. However, not being able to drive can be hard for the people because it limits their mobility and independence. Most states make allowances for people with epilepsy to drive again if their seizures are completely controlled and they have not had a seizure in at least two or three years.

Many children have been exposed to others having seizures at school. Experiences such as these can be frightening for the children viewing the event; they are not always sure what is going on. Sometimes those with epilepsy feel stigmatized by others. Sometimes as children they are made fun of by others. Experiences such as these can make people less likely to talk about the disorder with others. People with moderate to severe epilepsy also tend to have slightly lower IQs than average; on average, their intelligence would still be considered average but there are also other cognitive deficits associated with epilepsy. Many children with the disorder have many symptoms of ADHD — inattention, distractibility, and hyperactivity. Often they also have slower processing speed than average, meaning that they cannot process information as quickly and might even appear slower to others. This can impact performance at school, resulting in learning disorders and the need for special education classes, which can lead to further social stigmatization.

Problems also can develop at home when parents do not understand all the effects epilepsy can have (e.g., cognitive difficulties, emotional lability, and attention problems). Parents may not realize that their child is acting out because of how seizure activity interrupts the normal functioning of the brain. Parents may not link a child’s emotional problems to their seizures. Other parents might not realize that attention problems might be due to absence seizures. It is important for physicians and psychologists to correctly educate parents about the problems that might arise as a result of epilepsy. We have come a long way in our understanding of epilepsy, both from a scientific and general population perspective, but stigma and discrimination still occur too frequently.