Epilepsy

Risks, injuries and SUDEP from epilepsy

People face risks in all areas of life and people with epilepsy may face specific risks because of their epilepsy. These include injuries or accidents as well as risks to health and wellbeing because of seizures. The risk of sudden death is also higher for people with epilepsy than for others, and is discussed further below. Risks are very individual and depend on the type of seizures a person has and factors in their personal lifestyle. 

Looking at possible risks to health and safety, such as accidents, can be difficult or frightening and it may not be something that one is ready to think about. But being aware of possible risks and ways they might be reduced or managed can help put some of the risks around epilepsy into perspective. Here young people talk about their thoughts and concerns about risks, experiences of injuries and SUDEP (Sudden Unexpected Death in Epilepsy).

Risks and injuries

On the whole, young people we spoke with weren't particularly concerned about risks related to epilepsy. The main things that worried them were practical issues, such as having a safe home or work environment, safety in travel and driving or doing sports (see 'Driving, transport and travel' and 'Sport and exercise'). A few people worried about the possible impact of frequent seizures on their health.

People can injure themselves when they have seizures. These injuries can vary from very minor injuries to very serious, even leading to disability or death (for example drowning when having a seizure in bath). Many young people we spoke with had been injured, mainly minor scratches and bruises, but some had broken a limb or their teeth. One man got such bad facial injuries during a tonic-clonic seizure that he needed facial surgery afterwards. A couple of people had been burned after spilling boiling water over themselves.

To reduce the risk of injuries many people had made some adjustments to their homes (see 'Living arrangements and safety') or the ways they lived their lives. For example, some said that they took showers instead of baths or, if they did have a bath, they didn't lock the door, made sure the water level was low and the water not too hot. A seizure in water may lead to drowning and it is advisable to always have someone else present in the bathroom when having a shower or a bath. Although there are risks associated with showering they are not as great as having a bath and with reasonable precautions most people should be able to shower alone. A couple of people we spoke with were cautious because they had had a seizure in the bath or shower. A few people said that they felt silly or uncomfortable having the bathroom door unlocked. 

Some took extra care, especially in the kitchen, with hot water, cooking, with ovens and knives, or when using tools. A couple of people joked that the risk of having a seizure when handling glass or hot water was a great way to get out of cooking or washing up at home! Those people who had an aura before a seizure said the aura enabled them to get to a safe place before they became unconscious.

One woman said the reason she stopped smoking was because it could be dangerous if she had a seizure whilst smoking. Another woman had a safety pillow because she often had seizures when sleeping.

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A few people said that they didn't want to go out or to the shops on their own but felt safer going out with their friends. Some also carried medical jewellery with them, which had the necessary medical details and their ID in case they had a seizure when out on their own.

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In addition to risks related to injuries, a couple of people worried about the long-term effects of frequent seizures on their brain. Short, uncomplicated seizures that stop on their own are not thought to cause any permanent damage to the brain. Prolonged seizures or status epilepticus can be damaging. If recurring seizures do damage the brain, the type and duration of the seizures and the specific cause of the epilepsy may be important factors.

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Some people said that they felt lucky because their seizures were well controlled or because they felt the type of seizures they have didn't put them at a significant risk. Several said that they couldn't think about every possible risk there might be because then they'd never actually leave the house. 

One man said that it should be up to the individual to decide whether to change his or her lifestyle because of epilepsy, or choose to take some risks; “If it's your condition, it's your decision.”

Those who chose to avoid doing certain things, like swimming or travelling on their own, said there were many ways they could get around risks and enjoy most things they liked (see 'Driving, transport and travel' and 'Sport and exercise').

Many young people had been given information about practical ways to reduce their risk of injuries but some said they hadn't been told about any risks at all. Several wanted to get as much information from their doctors as possible and a couple of people pointed out how important it was to communicate information about risks sensitively and appropriately (see 'Experiences of health care services and professionals').


SUDEP

If a person with epilepsy dies suddenly and no other cause of death is found, it is called SUDEP (Sudden Unexpected Death in Epilepsy). SUDEP is connected to seizures but what exactly causes it, is unknown. The most likely explanation is considered to be a seizure which interferes with the part of the brain that controls breathing or the heartbeat. A few young people we spoke with had heard about SUDEP but none had been told about it by their doctors. People who talked about SUDEP were not especially worried about it though many would have liked more information about it. A couple of people knew of someone who had died of SUDEP and one woman's uncle had died of SUDEP.

Risk factors

A small number of people die early from SUDEP each year (about 1 in 1000 people with epilepsy in the UK). People's individual risk of SUDEP varies and there are ways to reduce the risk. This is why it is important for people to understand their individual type of epilepsy and how best to manage their condition.

Some factors that may be associated with a higher risk of SUDEP are the frequency of seizures (particularly tonic-clonic and complex partial seizures), having seizures during sleep, not taking AEDs as prescribed, abrupt and frequent changes to AEDs, being a young adult, and drinking excess amounts of alcohol or taking recreational drugs. 

Reducing risk

A key way to reduce the risk of SUDEP is to try and get the best seizure control possible. Correct diagnosis and treatment are vital. This should involve a referral to a specialist with an interest in epilepsy and agreed regular reviews with a health professional who has a good knowledge and understanding of epilepsy. For the right medication to be given at the right dose, the medical team will need precise and ongoing information about the number, frequency and type of seizures as well as the nature of any adverse effects experienced.

It is a good idea to raise any possible concerns about SUDEP with the consultant or epilepsy specialist nurse. See our resources page for links to more information on SUDEP.

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Young people had first come across information about SUDEP on various websites or in leaflets and it had come as a shock to them. One woman was really angry that her doctor had said nothing, and that she and her mum found out about it accidentally. 

All the young people we spoke with felt that information about SUDEP should be given more readily and openly. One woman said she feels it's a person's right to know and a doctor's duty to tell them everything about their condition. 

A couple of people pointed out that it's important to tell young people about SUDEP in a sensitive way and, if they're very young, to perhaps talk to their parents first. One woman said that it was enough for her to know that there was a risk of it but she didn't want to know more details. A few people emphasised the need for people to know about the risk of SUDEP so that they would appreciate the importance of seizure control and taking their medication regularly.

We also spoke to a couple of people who had lost a young family member to SUDEP. None of them had known about SUDEP or the risk factors. All of them would have wanted more information about SUDEP from the doctors when their family member was diagnosed with epilepsy, or soon afterwards.

One person said that people with epilepsy should be told about all the risks in the same way as people with asthma or diabetes, and their families are. People felt that knowing more about risks and SUDEP would have enabled them to ask questions, deal with factual information and fully appreciate the importance of minimising risk factors - for example having a regular routine, taking medication regularly as prescribed and avoiding drinking excessively.

Last reviewed May 2016.

Last updated March 2012.

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