[Epilepsy--inability to work and drive]

Epilepsy presents a diverse clinical picture and thus skill and expertise are required when evaluating a patient's inability to work. The assessment must be based on the individual's unique medical history (type of attack, triggering mechanisms, frequency of attacks, presence of an underlying primary disease or other sequelae, possible neuropsychological deficits). It is often the causal diseases or subsequent sequelae that are the actual restricting factors for the inability to work and not the fact, per se, that the patient suffers from epileptic attacks. Rare or occasional attacks seldom interfere with the ability to work. Adverse drug reactions occasionally evoke a restriction in activities. In order to be able to correctly evaluate the inability to work, an accurate understanding of the workplace is indispensable--a general description is by no means adequate. Only when this understanding has been gleaned can a possible danger to the patient or his co-workers be correctly evaluated. Likewise, an epilepsy-related inability to drive can be a significant restriction for certain jobs. When the inability to drive results in an inability to work likely to last for a prolonged period, plans for alternative employment should be made as soon as possible and include the parties responsible (employers, Social Insurance). Vocational training is another option that can be considered in these cases. However, before such anticipated new employment or retraining is undertaken, one must always ensure that possible epilepsy-related neuropsychological deficits do not pose concerns or restrict a particular rehabilitation option. This article presents a tabular summary of the Swiss Guidelines (2006 revision) concerning driving and epilepsy.