CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Epilepsy - Management
What psychological and social problems should I assess?
- Assess symptoms and signs of anxiety or depression and manage appropriately. For further information on the identification and management of depression, see the CKS topic on Depression.
- Assess how the person is managing their daily life with epilepsy.
- If the person is driving, or wants to drive, ensure that they are entitled to do so — see Medical Standards of Fitness to Drive for further information. Offer them the information leaflet on Epilepsy: Driving (eruk), produced by Epilepsy Research UK and available through CKS.
- It is the legal responsibility of the person with epilepsy to inform the Driver and Vehicle Licensing Agency (DVLA) about their condition.
- If they do not inform the DVLA and continue driving despite being advised to stop, the clinician should make every reasonable effort to persuade them to do so. If this fails, the clinician should inform the DVLA personally and write to the patient to explain what has been done.
- For people who are working or seeking work, ask about any problems they have with work relating to their epilepsy. If they are having difficulties, suggest:
- Offer verbal and written advice about managing the risks from epilepsy in their daily life. The following information leaflets are produced by Epilepsy Research UK, and available through CKS:
- The following leaflet is available from Epilepsy Action:
- Offer verbal and written advice on obtaining disability living allowance and other benefits. Information leaflets are available from Epilepsy Action including information on the Disability living allowance.
Basis for recommendation
- The recommendation to assess people for depression and anxiety is based on expert opinion [Elger and Schmidt, 2008]. It is recommended because there is evidence of a higher prevalence of these conditions in people with epilepsy.
- The lifetime prevalence of depression, suicidal ideation, and generalized anxiety disorders is twice as high in people with epilepsy than in the general population.
- The risk of suicide is highest in people with epilepsy who do not respond well to treatment.
- The recommendation to ensure that adequate verbal and written advice is provided for people with epilepsy and their carers is based on evidence, considered by the National Institute for Health and Clinical Excellence, that found that people are often given inadequate information about epilepsy and its treatment [NICE, 2004c].
- A systematic review identified 40 primary research papers published between 1990 and 2000 [Couldridge et al, 2001]. It found that individuals require more information on epilepsy in general, diagnosis, treatment options, medications and their adverse effects, seizures and seizure control, prognosis, injury prevention, psychological issues, social security, driving and insurance, employment, lifestyle, and social issues.
© NHS Institute for Innovation and Improvement