Epilepsy Driving and State Regulations

Driving can be challenging for people who have a seizure disorder. Accidents may occur due to a seizure disorder which puts the person at risk. In the United States, each State has specific guidelines and laws on the requirement for driving once the person is seizure-free.

Most people are able to drive again once their seizures are under control. In some States, a letter from the doctor is required. Below are regulations for each State:

State Regulations

Alabama- 6 Months with exceptions

Alaska- 6 Months

Arizona- 3 Months with exceptions

Arkansas- 1 year

California- 3, 6 moths with exception

Colorado- No set seizure- free period

Connecticut- Not set seizure- free period

Delaware- Not set seizure- free period

District of Columbia- 1 year

Florida- Upon Doctor’s recommendation

Georgia- 6 Months

Hawaii- 6 months with exception

Idaho- 6 months with strong recommendation from doctor

Illinois- No set seizure- free period

Iowa- 6 months less if seizure nocturnal

Kansas- 6 months less if seizure nocturnal

Kentucky- 90 days

Louisiana- 6 months with doctor statement

Maine- 3 months or longer

Maryland- No set seizure- free period

Massachusetts- 6 months- less with doctor statement

Michigan- 6 months- less at discretion of department

Minnesota- 6 months with exception

Mississippi- 1 year

Missouri- 6 months with doctor recommendation

Montana- No set seizure- free period, doctor recommendation

Nebraska- 3 months

Nevada- 3 months with exception

New Hampshire- 1 year/ less- discretion of the department

New Jersey- 1 year: less on recommendation of committee

New Mexico- 1 year, less on recommendation of advisory board

New York- 1 year with exception

North Carolina- 6-12, with exception

North Dakota- 6 months, restricted license possible after 3 months

Ohio- No set seizure free period

Oklahoma- 6 months

Oregon- 6 months with exception

Pennsylvania-  6 months with exception

Puerto Rico- No set seizure- free period

Rhode Island- 18 months. Less with doctor recommendation

South Carolina- 6 months

South Dakota- 6-12 months less with doctor recommendation

Tennessee- 6 months with acceptable medical form

Texas- 6 months with doctor recommendation

Utah- 3 months

Vermont- No set seizure – free period

Virginia – 6 months with exception

Washington- 6 months with exception

West Virginia- 1 year with exception

Wisconsin- 3 months, with acceptable medical form

Wyoming- 3 months

 

 

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When an Employee Has a Seizure

According to the National Epilepsy Foundation, 1 in 26 people will develop epilepsy in their lifetime. Epilepsy is a neurological disorder caused by abnormal nerve cell activity in the brain. Epilepsy involves recurring seizures.

More than 30% of people with epilepsy will experience generalized seizures.  It would not be unusual for a person to experience having a seizure in the workplace.When providing first aid for seizures, try to keep calm and make sure the person having the seizure is comfortable and safe from harm. A seizure can last from a second or several minutes.

Call 911 if:
  • The person has never had a seizure before.
  • the person has difficulty breathing or waking after the seizure.
  • The seizure lasts longer than 5 minutes.
  • The person has a seizure back-to back.
  • The person is injured during the seizure.
  • The person has an additional condition like diabetes, or heart disease.
Steps
  • Ease the person to the floor.
  • Turn the person gently onto the side (this will help the person breathe).
  • Clear the area around the person of anything hard or sharp
  • Put something soft and flat, like a folded jacket, under his or her head.
  • Loosen ties or anything around the neck including button on a shirt.
  • Time the seizure.
Familiarize Yourself With The Warning Signs 

Each person is different. Typically warning signs of a seizure may include:

  • Loss of consciousness
  • Stiffening of the body
  • Jerking of limbs
  • Slight twitching
  • A loss of awareness
Do Not:
  • Do not hold the person down or try to stop his or her movements.
  • Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
  • Do not try to give mouth-to-mouth breaths (CPR). People usually start breathing again on their own after a seizure.
  • Do not offer the person water or food until he or she is fully alert.

After the seizure:

After the seizure ends, the person will probably be groggy and tired. He or she also may have a headache and be confused or embarrassed. Try to help the person find a place to rest. If necessary, offer to call a taxi, a friend, or a relative to help the person get home safely.

Don’t try to stop the person from wandering unless he or she is in danger.

Don’t shake the person or shout.

Stay with the person until he or she is completely alert.

Source: Centers for Disease Control and Prevention

Source: National Institute of Neurological Disorders and Stroke

Apps For Tracking Seizures

Seizure apps are available on both iTunes and Android which journals seizure episodes. This allows people with epilepsy and parents to keep an accurate record of seizure occurrences.

Most apps include the following features.

  • Time and visually record seizures as they happen
  • Automatically add recorded seizures to the library
  • Help request are sent to your emergency contacts with your current locations
  • Information is organized into graphs to share with your medial provider

seizure-apps

All of the apps below are free, You will just need to download onto your phone.

iTunes

EpiDiary

Epilepsia App

Epilepsy Foundation- My Seizure Diary

Epilepsy Ireland Diary

Epilepsy Toolkit

EpiWatch

Neutun

SeizAlarm

Seizure Watch

Track It

Young Epilepsy

Android

Dr. Epilepsy

Epi Diary

Epilepsy App

Epilepsy Foundation

Epilepsy Help

Epilepsy Ireland Diary

Epilepsy Journal

Epilepsy Tool Kit

Epilepsy Tracker

My Seizure Diary

Seizure Alert and Recorder

Seizure Now

Soterria Seizure Alert

Android- Cost.

Seizure Now- .99

 

 

 

 

Epilepsy Facts

Epilepsy is a disorder of the central nervous system often caused by abnormal electrical discharges that develop into seizures. The following are additional facts on epilepsy and seizures:

30-epilepsy-facts

  • More people live with epilepsy than autism, spectrum disorders, Parkinson’s disease, multiple sclerosis and cerebral palsy combined.
  • You can’t swallow your tongue during a seizure. It is physically impossible.
  • You should never force something into the mouth of someone having a seizure.
  • Don’t restrain someone having a seizure.
  • Epilepsy is not contagious .
  • Anyone can develop epilepsy.
  • Epilepsy is not rare.
  • 1 in 26 Americans will develop epilepsy in their lifetime.4An estimated 3 million Americans and 65 million people worldwide live with epilepsy.
  • In 2/3 of patients diagnosed with epilepsy, the cause is unknown.
  • Up to 50,000 deaths occur annually in the U.S. from status epilepticus (prolonged seizures). (SUDEP) and other seizure-related causes such as drowning and other accidents.
  • SUDEP accounts for 34% of all sudden deaths in children.
  • Epilepsy costs the U.S. approximately 15.5 billion each year.
  • A seizure is a transient disruption of brain function due to abnormal and excessive electrical discharges in brain cells.
  • Epilepsy is a disease of the brain that predisposes a person to excessive electrical discharges in the brain cell.
  • It is diagnosed when 2 or more unprovoked seizures have occurred.
  • It must be at least 2 unprovoked seizures more than 24 hours apart.
  • About 14% have simple partial seizures.
  • 36% have complex partial seizures.
  • 5% have tonic-clonic seizures.
  • Seizures can be caused by head trauma, stokes, brain tumor and a brain infection.
  • Causes are unknown in 60 to 70% of cases.
  • The prevalence is 1% of the U.S. population.
  • Approximately 2.2 to 3 million in the U.S. have seizures.
  • It affects all ages, socioeconomic and racial groups.
  • Incidents are higher in children and older adults.
  • Seizures can range from momentarily blanks to loss of awareness
  • Almost 150,000 people in the U.S. develop epilepsy every year.
  • No gender is likely to develop than others.
  • 1/3 of individuals with autism spectrum disorders also have epilepsy.
  • The prevalence of epilepsy in people with an intellectual disability is higher than the general population.

Epilepsy- General Information

Epilepsy is a chronic disorder of the central nervous system. It is often characterized by seizures and is the fourth most common neurological disorder and affects people of all ages.

epilepsy ribbon

A person is considered to have epilepsy if they meet any of the following conditions:

  1. At least two unprovoked seizures occurring greater than 24 hours apart.
  2. One unprovoked seizure and after two unprovoked seizures occurring over the next 10 years.
  3. Diagnosis of an epilepsy syndrome.
Seizures

A seizure is caused by a burst of abnormal activity in the brain. With a seizure, a person has change in awareness, behavior, body movement or sensation. A seizure can last from a few seconds to a few minutes. Seizures can take on many different forms and affect people in different ways.

Auras

Auras are often describes as a warning before the occurrence of a seizure. Not everyone experiences an aura. Some have described it as a change in feeling, sensation, thought or behaviors. this may include:

  • An overpowering smell.
  • Nausea or indigestion.
  • A rising/sinking feeling in the stomach.
  • a sleepy/dreamy feeling.
Types of Seizures

Generalized Tonic Clonic Seizures. Involves the entire brain. May also be referred to as a grand mal seizure. This occurs when abnormal electrical activity affects all or most of the brain. often the body will stiffen and then the person will lose consciousness and then the body will shake due to uncontrollable muscle contractions.

Absence Seizure– A brief loss of consciousness or awareness. It generally last only seconds and mainly occurs in children. Signs may include a blank stare, lip smacking and repeated blinking, chewing or hand movement.

Focal Seizures– The burst of electrical activity is contain in one part of the brain. In a simple focal seizure, you may have muscular jerks or strange sensations in one arm or leg. The person does not lose consciousness or awareness.

Causes
  • brain trauma
  • genetics
  • stroke
  • tumors
  • brain infections
  • head injury.
Risk Factors
  • Babies who are born small for their age
  • Babies who have seizures in the first month of life
  • Cerebral Palsy
  • Autism Spectrum Disorders
  • Conditions with intellectual and developmental disabilities
  • Family history of epilepsy (febrile)
Triggering Factors
  • Stress or anxiety
  • Lack of sleep or tiredness
  • Skipping meals
  • Alcohol intake
  • Flickering lights
  • Fever
  • Caffeine
Diagnosis
Treatment

 

The following websites offer additional information on epilepsy including causes, symptoms, treatment, and diagnosis:

Centers for Disease Control and Prevention

Epilepsy Foundation

Mayo Clinic

Medical News Today

Medlineplus

National Institute of Neurological Disorders and Stroke 

WebMD

Wikipedia

None of the information provided is meant to treat or diagnose any conditions. Not is it a substitute for medical, or psychological diagnosis and treatment.

What You Need To Know About Dravet Syndrome

Epilepsy is the 4th most common neurological disorder in the United States. With children, around 400,000 have epilepsy and most are able to control their seizures and lead normal lives. Dravet Syndrome is a rare form, of epilepsy found in children. Symptoms include, developmental delays, sleeping conditions, and chronic infections. Here are 20 facts you shoud know about Davet Syndrome.

20facts.dravet

  • Charlotte Dravet first described severe myoclonic epilepsy of infancy in France, 1978.
  • The name was later changed in 1989.
  • It is also called Severe Myoclonic Epilepsy of Infancy (SMEI)
  • It is a rare genetic disorder affecting 1 in every 20,000-40,000 children
  • It appears during the first year of life.
  • Seizures are often fever-related.
  • It is rare to develop beyond the age of 5.
  • Children often experience poor development of language and motor skills
  • Is caused by defects in a gene in 79% of cases.
  • Affects 2-5% of children in North America
  • It is induced by prolonged exposure to warm weather
  • It is associated with sleep disorder including insomnia
  • Seizures are frequently resistant to treatment
  • There is a higher risk of Sudden Unexplained Death in Epilepsy (SUDEP)
  • The onset of signs and symptoms is around 6 months around the time of the first vaccination.
  • Children typically outgrow seizures prior to adolescence.
  • Children diagnosed with Dravet Syndrome have a 85% chance of survival.
  • Development is typically normal.
  • Episodes may be frequent and prolonged
  • Certain seizure medications are likely to worsen the seizures such as Dilantin, Cerebyx and Tegretol.

Resources

Dravet Syndrome Foundation
P.O. Box 16536
West Haven, CT
Tel. 203-392-1950

Dravet Syndrome UK
P.O. Box 756
Chesterfield
5439EB
Tel. 07874 866937

Epilepsy Foundation- Provides online resources on information about epilepsy and seizures, locating assistance, advocacy and public awareness.

ICE Epilepsy Alliance– Provides resources on refractory patients (anti-epileptic drug therapy which is ineffective). Site includes information on advocacy, childhood epilepsy, and Dravet syndrome.

NINDS Dravet Syndrome Information Page– Medical information page on Dravet syndrome, diagnosis, treatment, research and organizations.

WebMD– Medical website providing information on diagnosis, signs and symptoms, and treatment.

Ohtahara Syndrome

ohtahara

What is Ohtahara Syndrome?

Ohtahara Syndrome is a rare type of seizure that affects infants and newborns. It is generally diagnosed before the age of 3 months. After several months, seizures may turn into West Syndrome or Lennox- Gestaut Syndrome.

Other Known Names
  • OS
  • Early Infantile Epileptic Encephalopathy
  • Early Infantile Epileptic Encephalopathy with Suppression Burst
Causes
  • Brain malfunctions
  • Metabolic disorders
  • Certain gene mutations
Symptoms
  • Tonic spasm
  • Focal spasm (partial) motor seizures
Diagnosis and Testing
  • EEG- records the electrical activity in the brain
  • MRI
  • Bloodwork
Treatment
  • May be resistant to epilepsy medication. The following medication may be used: Phenobarbital, Clobazam or Vigabatrin.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment or medical condition.

 

 

 

Lennox- Gastaut Syndrome

lgsribbon
What is Lennox-Gastaut Syndrome?

Lennox-Gastaut Syndrome is a type of epilepsy where a person may experience multiple types of seizures including tonic (stiffening of the body), atonic (brief loss of muscle tone), and atypical absence  (starring). This type of seizure often begins during infancy and early childhood.

Statistics and Facts

4% of children with epilepsy are diagnosed with Lennox-Gastaut Syndrome with more of a prevalence in males than females. Most mortality rates are due to accidents.

Other Known Names

LGS

Symptoms

Symptoms often include frequent seizures and multiple types of seizures including:

  • Atonic seizures (drop attacks)- a sudden loss of muscle tone and limpness, a person may suddenly fall which can lead to head injuries.
  • Tonic seizures- the body stiffens and can last for up to a minute. Will generally occur when the person is asleep.
  • Abnormal seizures- a period pf unconsciousness where the person has no memory of the episode.

Causes

  • Abnormal development of the brain cortex
  • Congenital infections
  • Stroke
  • Trauma
  • Lack of oxygen during birth
  • Encephalitis
  • Meningitis
  • Tuberous Sclerosis
  • Seizures that start in infancy referred to as West syndrome

Diagnostic and Test

  • Clinical evaluation
  • Detailed patient history
  • Complete physical and neurological evaluation
  • Electroencephalography (EEG)
  • Magnetic Resonance Imaging (MRI)
Treatment
  • Anti-epileptic drugs (AED’s)
  • Dietary therapy
  • Surgery (VNS therapy)

 

Disclaimer: this article is for information only and should not be used for the diagnosis or treatment or medical condition.

West’s Syndrome

west5

What is West’s Syndrome?

The average onset generally begins at an average age of 6 months. Symptoms may include a pattern of an infant bending forward with a stiffening of the body, including the arms and the legs. Each episode generally last for a few seconds. These episodes typically occurs I clusters that can last up to 20 minutes.

Causes
  • Trauma
  • Brain malfunctions
  • Infections
  • Down syndrome
  • Tuberous sclerosis complex
Statistics and Facts

West syndrome occurs 1 in every 2,000 to 6,000 live births, which peak between the ages of 4 and 7 months old. 90 percent of incidences occur before the age of 1 year. West syndrome accounts for approximately 30 percent of incidences involving infants. Boys are more likely to be affected than girls.

Other Know Names
  • Generalized Flexion Epilepsy
  • Infantile Epileptic Encephalopathy
  • Infantile Myoclonic Encephalopathy
  • Jackknife Convulsions
  • Massive Myoclonia
  • Infantile Spasms
  • Salaam Spasms
History

Initially discovered in the 1840’s by Dr. William James West when he noticed his own son, James E. West showed the characteristics of “bobbings” that caused a complete heaving of the head towards his knees and then immediately relaxing to the upright position. Dr. West originally coined the phenomena as “Salaam Tics”.

Diagnosis and Testing
  • Electroencephalography (EEG)
  • A physical and neurological exam
  • Computer Tomography (CT)
  • Magnetic resonance Imaging (MRI)
  • Blood Test
  • Urine Test
  • Wood Lamp (for the purpose determining if tuberous sclerosis is a possible diagnosis)
Treatment
  • Steroid therapy by injection into a muscle or prednisone by mouth
  • A seizure medication called Sabril
  • Ketogenic diet

 

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.

Benign Roladric Epilepsy

Benign Rolandic Epilepsy

epilepsy ribbon

What is Benign Rolandic Epilepsy?

Benign Rolandic Epilepsy is a type of seizure that affects primary children. It is referred to as “Benign” since most children grow out of it during puberty and “Rolandic” describes the part of the brain where seizures begin.

Other know names:

  • benign focal epilepsy
  • benign childhood epilepsy with centrotemporal spikes (BCECETS)
  • benign rolandic epilepsy of childhood (BREC)
  • benign epilepsy with centro-temporal spikes (BECTS)

How Common is Benign Rolandic Epilepsy?

Benign Rolandic Epilepsy (BRE) is considered one of the most common types of epilepsy children will experience. It generally begins between the ages of 3 and 13 and peaks around the age of 7-8 and will stop around the ages of 14-18 (puberty). Children usually do well with this type of seizure although some may experience learning disability including reading, language and drawing.

Symptoms

  • A feeling of tingling on one side of the mouth which involves the tongue, lips, gums and inner side of cheek.
  • Generally begins when the child is sleeping or wakes up in the morning characterized by occurring in clusters and long intervals with no seizure activity.
  • twitching movements on one side of the face.
  • May make gurgling sounds.
  • Drooling and the inability to speak.
  • Day time seizures may be infrequent and typically last less than 2 minutes.
  • May spread from the rolandric area to the rest of the brain which becomes a tonic-clonic  seizures.

Diagnosis

Diagnosis are done through an accurate history of the seizures and an electroencephalogram (EEG) test, which picks up seizure activity.

Treatment

In most cases, children may not take any medication since the seizures end around puberty. May be treated with anti-epileptic drugs including:

  • Carbamazepine
  • Levetiracetam
  • Oxcarbazepine

How professionals can help

  • Recognize the signs of seizures
  • Teachers should be aware that a child may often feel tired and sleepy afterwards for hours
  • There may be learning difficulties and behavior problems

Resources