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(LGV) or Passenger Carrying Vehicle (PCV) driving licence, an individual must have
suffered no seizures or had no treatment for seizures for ten years (see Chapter 54). However,
regulations can change so it is important to make sure information is up to date.
Unemployment
Quoted unemployment rates vary widely. Figures cited for vocationally active people with
epilepsy are at least twice that of the general population. Elwes and co-authors reported an
unemployment rate of 46% for people with epilepsy, as opposed to 19% for a control group10.
Significantly longer periods of unemployment and higher rates of early retirement are also
reported. When epilepsy is well controlled, or seizures are nocturnal, it has much less impact
on employment rates and history. Rates of underemployment are reported to be higher for
people with epilepsy but these rates are more difficult to quantify. However, the majority of
studies investigating employment and unemployment rates among people with epilepsy have
been based on highly selected populations or small samples. In a 1995 study by Jacoby on a
large cohort of people with relatively well controlled epilepsy, 71% of those of working age
were in employment with 26% unemployed but for reasons other than epilepsy and only 3%
citing epilepsy as the reason for not working11. A breakdown of employment rates by clinical
and demographic factors is displayed in Table 1.
Table 1. Influence of demographic and clinical characteristics on current employment status.
% Currently Number of
employed patients
Sex
Male 79 213
Female 64 266
Age at which first education completed
<16 67 340
17+ 81 139
Epilepsy was
Active 65 121
In remission 73 348
Currently taking AEDs
Yes 67 355
No 70 139
Self-assessed health status
Excellent/good 75 398
Fair/poor 49 79
Neurological deficit
Yes 70 406
No 71 73
Seizure type
Partial 53 32
Partial with secondary generalised 74 160
Generalised 70 286
Reproduced with permission from Jacoby 199511
Work performance
Assessing productivity is difficult as there is no agreed definition or means of testing it. To
obtain data on the effects of epilepsy, comparisons should ideally be made with a person who
does not have epilepsy performing the same task. The available evidence does not suggest
any striking lack of efficiency at work in employees with epilepsy. One study of an electrical
components firm recorded reduced working speed but this was reported to be associated with
an increase in precision, which was considered a positive outcome.
