Questions Law Enforcement Officers Most Often Ask about Epilepsy

Questions Law Enforcement Officers Most Often Ask about Epilepsy

Are seizures a medical emergency?

When a seizure occurs in a person who has epilepsy, and the seizure ends without injury after a minute or two, it is not usually considered a medical emergency, although the person should be asked a) if he or she has epilepsy, b) if he or she has fully recovered, and c) if he or she wants medical attention.

When a seizure occurs and you don’t know whether the person is someone with epilepsy, or whether this is a first-ever seizure for this person, the possibility of a serious medical problem is greater. Calling for medical assistance, but giving the person the opportunity to decline it if he or she wants to, is one option that some law enforcement agencies use. Consult individuals on the scene, look for medic alert symbols to determine whether the individual has epilepsy.

If the seizure lasts longer than five minutes, if another seizure starts shortly after the first without consciousness returning, or if the person is injured, diabetic, pregnant, or the seizure occurred in water, emergency medical assistance should be called.

Is epilepsy a disease?

No. Epilepsy is a disorder of the brain. It is a temporary malfunction of the normal electrical system in the brain which controls movement and awareness. Anyone can have a seizure if the brain is injured or stresses enough with fever or some poisonous substance, including illegal drugs. People with epilepsy have a tendency to experience seizures as a result of past injury or a greater susceptibility to these electrical changes.

Epilepsy is the most common of all long term neurological disorders.

Is epilepsy contagious?

No. You cannot catch epilepsy. You cannot give it to anyone else.

Are people with epilepsy born with it?

Some people have seizures shortly after birth and continue to have them throughout their lives, but this is a very small number. Others will develop epilepsy in childhood or later in life as a result of things which injure the brain – trauma, serious infections, metabolic problems. Often there is no known cause, in which case people may have an inborn tendency to develop the condition.

Can people with epilepsy swallow their tongues?

No. It is not possible to swallow your tongue. Occasionally, the tongue will block the airway (which is why the “swallowing” myth developed), but this can be prevented by placing the person on one side, allowing gravity to keep the airway clear of the tongue and any fluids in the mouth. You should never try to pry open the mouth when someone is having a seizure. It will not aid breathing and it may seriously damage teeth and jaw.

What is the most common medication for people with epilepsy?

Seizure type (and sometimes cost) affects which medicine is prescribed. Phenobarbital is relatively cheap, treats most types of adult seizures, and is still used extensively. Carbamazepine (Tegretol) and phenytoin (Dilantin) are also widely used. Primidone (Mysoline), valproate (Depakene or Depakote), and ethosuximide (Zarontin) are also frequently prescribed. There are several other preparations that are used less often but which may be carried by people with epilepsy, including Valium and Tranxene.

[Note: Current information about epilepsy medication can be found here.]

Can people with epilepsy drive legally?

Yes, if they meet the requirements of the local department of motor vehicles. These requirements usually consist of a period of complete freedom from seizures (anything from three months to a year, depending on the state) and may include a letter from a treating physician. People who have seizures despite medication will not be licensed and therefore cannot drive legally. A few states will license if special circumstances exist (seizures only at night, for example, or always with a warning, or they may allow for a restricted license that permits driving only to local stores, or in daylight hours).

How common is epilepsy?

It is very common. It is the most common chronic neurological condition.

It affects nearly three million people in the United States. People living to be eighty years old have a ten percent chance of having had a seizure at some point in life, and a four percent chance of being diagnosed with epilepsy (recurring seizures).

Can epilepsy be cured?

In some cases, surgery can remove the area of the brain which is causing seizures and no more seizures occur. But for most people, treatment is through regular use of one or more anticonvulsant drugs. The medicines do not cure, although some people have been successfully withdrawn from them after some years of seizure control.

What’s the connection between seizures, law enforcement officers, and the Americans with Disabilities Act?

Having seizures, from whatever cause, is a medical event beyond individual control. Susceptibility to seizures (epilepsy) is a disability covered by the Americans with Disabilities Act (ADA). The ADA outlaws discriminatory treatment towards people with disabilities by employers and by people like the police who provide services to the public. Being arrested because of behavior cause by a disability violates the ADA, in that people are being singled out for special treatment based solely on their disability. With training, these situations will no longer occur.

Should I give the person anything to drink after a seizure

Not until you are sure he or she is fully conscious, able to interact normally, and completely recovered from the seizure.

Can a person die from a seizure?

It is possible to die from a single seizure, though very rare. What is more likely to happen is injury or death from the setting in which the seizure took place – that is, from hitting the head on a concrete floor or other hard surface, a fall from a height, or drowning if the seizure occurs in water. Non-stop seizures are a true medical emergency and can result in death. A common cause of non-stop seizures is failure to take medication on schedule. There have been causes of fatalities in jail when prisoners with epilepsy were unable to maintain their medication schedules, leading to dangerous re-bound convulsions that became continuous. Death from seizures while in custody can also occur if the seizure is ignored, if the person chokes on vomit, if he or she falls and injures themselves or falls in such a way that breathing is obstructed.

How can an officer tell if a person is faking a seizure?

Distinguishing between a seizure and other impaired behavior is tough enough; trying to distinguish between real and fake seizures in the field is beyond reasonable expectations of an officer. It is better to treat an episode of falling and shaking followed by confusion, or an episode of confusion that start abruptly and slowly resolves itself as a real seizure than to risk making a mistake in the other direction.

What happens if someone is faking a seizure and I respond as if it is real?

If you follow standard procedures and stay alert, there is no down side to reacting to a faked seizure as if it is a real one. If the faked seizure is designed to mislead an officer, delay questioning, or to draw attention to the individual for some reason, appropriate police follow up can still take place once the “seizure” ends. Even a fake seizure has to end, at which point the officer can continue questioning and explore the reason for the “seizure” by inquiring about seizure history, treatment, name of doctor, and if necessary, can still arrest the individual if a crime has occurred.

Do people with seizures have a mental illness?

Epilepsy is not a mental illness. It is a temporary change in the electrical function of an otherwise normal brain. Some people with mental illness also have seizures, and some people with seizures also have mental illness, but the two conditions are not the same.

How can you tell the difference between seizures and intoxication?

Seizures have a sudden beginning, a progression of symptoms, and a gradual recovery. Intoxication begins slowly and takes much longer to subside. Sometimes an intoxicated person will have a seizure, in which case there will be a strong odor of alcohol in addition to the seizure-cased behavior. In that case, the seizure will resolve, but return to full consciousness will not be as obvious. Whatever the cause, the seizure needs to be handled appropriately.

Do epilepsy medications have side effects?

Yes, and occasionally they can resemble intoxication, producing slurred speech, unsteady gait, and sleepiness. This can happen if the dose of medication is very high, or if something has interacted with the drug to produce a higher than usual concentration in the blood. These effects are most likely at the beginning of treatment or if the person has to take large doses to control seizures. Sometimes the medicines have a slowing effect on speech, although otherwise the person can function normally. For most people, however, the side effects do not interfere with a normal life.

Do most people with epilepsy wear medical ID?

No, some people do not wear medical identification. However, many do. They wear ID bracelets or necklaces and these should always be looked for and checked in cases of possible seizure.

Are seizures dangerous to others?

Not usually. The overwhelming majority of seizures are either convulsions or brief alterations of consciousness during which movements are vague, non-threatening, and primitive. During these episodes, directed violence or any complex actions requiring organized thought are unlikely to occur. Clumsy, undirected violence is possible when people are restrained during a seizure, or during the period of confusion following a seizure. In rare cases, a seizure will take the form of screaming, running, and flailing movements which could possibly injure someone who does not move out of the way. Again, the movements during this period will be primitive and reflexive rather than directed.