[Extensive rehabilitation needed in epilepsy. Different models for varying needs]

Many people with epilepsy experience the need for more information concerning their condition and some people require, at times, greater access to rehabilitation services than has previously been available. Information and support may also be required by the family, friends and work colleagues of the patient. Research indicates that rehabilitation needs, for the patient, can arise in relation to poor self-esteem, overprotection as a child, low expectations, reduced cognitive abilities and stigma perceived or experienced in the family, in society, and at work. Successful rehabilitation is individualistic and should therefore be based on an assessment of the individual's needs. Only on the basis of this can realistic goals be identified. In the cases where intensive multidisciplinary rehabilitation is required a thorough medical assessment will also be needed in order to formulate realistic goals. Achievement of these goals may involve input from psychological, neuropsychological, pedagogical, social, employment and family orientated perspectives. Specialists in these areas must be included within, or co-ordinated by, the epilepsy team or rehabilitation service. In Sweden hospital based epilepsy-teams have added psycho-social rehabilitation aspects in their responsibilities and other rehabilitation services have recently begun to focus on the needs of people with epilepsy. This has led to a range of different rehabilitation models being available. The need to develop improved epilepsy rehabilitation services was identified in the 1970s and has recently received short-term funding support to develop new services and build up expertise. It is hoped that in the future these services will continue to find support at both the county and national levels.