Socio-medical problems of epileptics. A preliminary report.

Abstract

ABSTRACTIn the Department of Neurology, Aarhus Kommunehospital, which has both an in‐ and an out‐patient clinic, an investigation is in progress in which all adult epileptics with a duration of symptoms of at least 12 months are included. In the final analysis, only patients with a duration of at least 5 years will be considered. The clinical and social conditions of all the patients are recorded, so that it will later be possible to assess the medico‐social prognosis for adult patients with epileptic seizures who consult our Department, which serves a population of about one million.To date, the study comprises 736 adult epileptics, on whom a preliminary analysis has been made.The purpose of the study is to throw light upon the social difficulties encountered by epileptics, and on the basis of medical, social and psychological considerations to trace the groups in which social rehabilitation is possible.After exclusion of disability pensioners and married women, the series consists of 425 patients. Among these, there were only 21 men and 2 women in mhom occupational difficulties solely referable to epilepsy could be demonstrated. As the duration of symptoms in some of the patients ranges between one and two years, the numbers reported are obviously minimum figures, since difficulties will undoubtedly later be experienced by some of the remaining patients, In addition, some of those who now receive disability pension would probably have been able to manage without this if active measures aiming at relieving their difficulties had been taken at an earlier time.The series was classified according to the types of epilepsy, and a distinctly significant difference was found between the groups of epilepsy of unknown cause and symptomatic epilepsy, of which the former group had the best social prognosis.It was also found that patients with temporal seizures did not show any social deterioration as compared with other epileptics.An analysis in which the severity of epilepsy and the psyche were related to the social conditions showed that among patients with mild epilepsy and “normal” psyche, 87 per cent of both men and women had no occupational difficulties, whereas among those lvith the combination of severe epilepsy and psychic deviations only 15 per cent of the men and 35 per cent of the women had not experienced social deterioration.During recent years, a certain optimism has been voiced as to the occupational possibilities open to epileptics, and this optimism has coincided with an increased interest in rehabilitation of patients in general. However, although some positive results have been obtained, rehabilitation of epileptics presents considerably greater problems than that of other patients. Thus, a follow‐up study of patients who since 1945 have received financial support for vocational training and rehabilitation from the Danish Disability Insurance Tribunal shows that the possibilities of rehabilitating epileptics are very limited. As the patients who received this support belonged to a selected group in which all the members, according to close examinations and observations, were characterised as suited for an attempt at vocational training, the poor results obtained show that in the future work, the measures taken to relieve the social difficulties of epileptics must be related to the results which can reasonably be expected.