Seizing the day

December 31, 2008

Subject to sudden unexpected seizures, epileptics are often a subject of discrimination in the workforce. Many employers are hesitant to hire epileptics, fearing that stressful workplace situations might bring on an attack. But a new Tel Aviv University study suggests these fears are groundless.

New research findings from Dr. Shlomo Moshe of TAU's Sackler Faculty of Medicine show that occupational stress has no effect at all on the incidence of epilepsy attacks. The research also gives physicians and employers important information to assess the health and safety of prospective employees who suffer from the disease. It especially benefits those who have been seizure-free for a long period of time, because indicators show they are likely to stay seizure-free.

"People are prejudiced against epileptics, who learn how hide their condition very well," says Dr. Moshe. "It becomes a problem when they're trying to get work, because most employers avoid hiring epileptics. But occupational physicians have been asking for years, 'What are the real risks?' Our new study provides the answer."

Unprecedented in Size and Predictive Power

According to the Epilepsy Foundation, more than 3 million Americans suffer from epilepsy and 200,000 new cases are diagnosed every year. One in 10 adults will have a seizure sometime in their lifetime. There is no cure for the disorder, and even when it's in remission, there is a strong stigma against people with epilepsy.

The largest of its kind ever conducted, Dr. Moshe's study, recently reported in the journal Epilepsia, surveyed over 300,000 people with no history of epilepsy and compared them to a sample of 16,000 epileptics. The last major study to investigate the risk of occupational stress on epilepsy, reported a few years ago by the New England Journal of Medicine, was based on a sample size of only 200 people, making this new Tel Aviv University study a real first in medical history.

With such a large sample size, Dr. Moshe is able to predict with high levels of certainty when ― and whether ― seizures might strike. This will reassure those with the disease, as well as the employers and insurance companies who provide health coverage for them.

"We proved with very high levels of predictability that we can pinpoint the chances of a person having another seizure," says Dr. Moshe, who is also a practicing physician at Maccabi Healthcare Services, an occupational health clinic in Tel Aviv. "For example, if we see that someone had their last attack as a child, we can show that their chances for a full remission of epilepsy are quite high."

A Matter of Timing

Over a period of three years, the researchers in the Israeli study compared the rate of seizures to the types of duties each group of subjects was assigned to perform -- manual labor, combat fighting, or office work.

"The type of assignment didn't affect a person's chance of having a seizure at all. The biggest predictor of recurrence is time -- when the last seizure struck. Those that had seizures more than five years ago have little to worry about today," Dr. Moshe advises.

Source: American Friends of Tel Aviv University