Page 484 - ILAE_Lectures_2015
P. 484

(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.
   479   480   481   482   483   484   485   486   487   488   489