Epilepsy is a neurological disorder that can affect people of all ages. According to the WHO, some 50 million people around the world have epilepsy and an estimated 2.4 million new diagnoses are made each year. The condition has significant implications for life and health insurance because it is associated with loss of productivity, increased healthcare needs and even premature death.

The mortality rate among people with epilepsy is two to three times higher than the rest of the population.^1,2 Fatal injury, drowning, suicide, sudden unexpected death in epilepsy (SUDEP) and so-called status epilepticus (involving multiple seizures without recovery in between) are all linked with the condition.³ Patients with remote symptomatic epilepsy and neurological deficits present the highest risk.⁴ People with epilepsy also have a higher prevalence of comorbidities, especially psychological disorders, such as depression and anxiety.

Powerful convulsions followed by a loss of consciousness, known as tonic-clonic seizures, often come to mind when we think of the effects of epilepsy. This over-dramatised image of the effects of the condition is often perpetuated in film and other media. The reality is that most epilepsy is manifested by much less alarming and transient “absence attacks”.

However, fear and misunderstanding of epilepsy can result in social stigmatization. Advocacy groups have increased awareness and reduced popular misconceptions. For example until the 1970s in the U.S., people known to suffer seizures could be denied access to restaurants, theatres and other public buildings.⁵

Although levels of discrimination are much reduced today, some people find that stigmatization can still exacerbate the difficulties they face and negatively impact their psychological well-being and quality of life.

Epilepsy is a relatively common condition, and it has a wide spectrum of severity. It is important to recognise that most patients are seizure-free and not limited in their day-to-day lives. However, some obvious occupational restrictions remain; for example, work that involves using certain machinery, operating vehicles or working at heights poses particular dangers. Epilepsy is an insurable condition. Applications for life and health insurance should be assessed carefully in every case since the underlying cause and levels of medical control significantly influence the prognosis.

International Epilepsy Day, held this year on 13 February, aims to promote awareness and highlight some of the medical and social aspects of this complex condition around the world.

Endnotes

1. Lindsten, H, Nyström, L, and Forsgren, L, Mortality risk in an adult cohort with a newly diagnosed unprovoked epileptic seizure: a population-based study, Epilepsia, 2000. 41(11): p. 1469 – 1473.
2. Sillanpää, M and Shinnar, S., Long-term mortality in childhood-onset epilepsy, New England Journal of Medicine, 2010. 363(26): p. 2522 – 2529.
3. Status epilepticus is a condition in which epileptic fits follow each other without recovery of consciousness between them.
4. Elger, CE, Underwriting Focus 2/2016, Gen Re Business School: p. 1 – 5.
5. Hesdorffer, DC, et al., Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure, Epilepsia, 2009. 50(5): p. 11 – 8.