Social aspects of epilepsy in childhood and adolescence

Epilepsy differs from other chronic conditions because of the unpredictability of the seizures, the absence of an absolute diagnostic test other than video-telemetry and the stigma associated with the condition. Working from a hospital base with a biased population, one might be forgiven for thinking that most people with epilepsy have major problems either of seizure control or socially. This is naturally not the case, but the social problems of epilepsy are sufficiently frequent and/or severe to warrant comment. Simply making the diagnosis may produce parental anxiety and guilt. This is often compounded by societal misunderstanding of epilepsy and the incorrect association with mental illness. Furthermore, it is those children or adults who have severe epilepsy who stand out in society, with the tacit implication that all epileptics (people with epilepsy) are like them. There is a societal generalization that all epileptics are the same. It is not appreciated that there are many types of epilepsy (convulsive and non-convulsive) and that epilepsy varies from being very mild to intractable. Treatment also has implications: children and adolescents may not like to take, or be seen to be taking, medication. It is desirable where possible to recommend twice daily dosage with breakfast and dinner. This avoids the need to take medication to school, or in the case of adolescents, to work. In addition, compliance is enhanced with a twice daily dosage. There is without doubt a stigma associated with epilepsy which persists despite being to a less degree than in the past.(ABSTRACT TRUNCATED AT 250 WORDS)