Although epilepsy tends to be a lifelong condition, effective management is available for most, allowing a seizure-free, productive life. Most occupations and recreational activities are open to people with controlled epilepsy, and most countries allow driving after a seizure-free period of 6-12 months (on or off medication).
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Complications of seizures can occur in many forms. Although seizures themselves tend to be self-limiting, the consequences of abruptly losing contact with the environment can be dangerous. These include: accidents while driving, bathing, swimming or using machinery; injuries sustained from falling or trauma to flailing limbs; and aspiration of vomit, leading to choking or aspiration pneumonia.
Status epilepticus refers to seizures that do not stop, or are so close together that consciousness is not regained. In this serious circumstance, respiratory and metabolic failure occurs, and mortality is high, even with intensive care treatment.
Even when seizures do not directly threaten life or limb, the condition can be damaging. If absence seizures are not recognized in children, these brief interruptions of attention throughout the day can lead to learning disability. Older children and adults may find the prospect of seizures so socially embarrassing or frightening that they withdraw from the world. Explanation of the condition, the broader education of the public, and contact with other people affected by seizures can do much to alleviate this.
Lastly, all anti-epileptic drugs have side-effects, and in an individual patient this often governs the choice of agent. Most of these side-effects are reversible and simply represent individual intolerance to a particular medication or excessively high dose. Rarely, side-effects can be unpredictable and serious. Pregnant women need especially careful choice of medication, and younger women who may fall pregnant need effective contraceptive advice. All women who are considering falling pregnant should take supplements of folic acid.
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