Department of Neurology

Epilepsy and denial

Q: I am looking for information that will help an elderly friend accept that she has a seizure disorder. This person is 70 and determined to stick to her self diagnosis that her seizures are a result of hypoglycemia despite her Drs. evidence to the contrary. She will not give up her car keys and is reluctant to take the Dilantin her Dr prescribed. If anyone has dealt with a similar situation I'd appreciate any advice they have to share. Thanks.

A: As epileptologists, we make the distinction of whether seizures are "acutely symptomatic," that is, whether it is cased by a transient derangement, or whether they occur under relatively normal conditions, suggesting that it is epilepsy. The former is usually not treated with seizure medications. Whether your friend's seizures are due to hypoglycemia or not must be carefully sorted by her physicians.

However, in most states driving is restricted for loss of consciousness irrrespective of cause, not just epilepsy. So whether she has blackouts from heart problems, diabetes or epilepsy makes no difference with respect to driving regulations, and your friend would be restricted from driving whether her seizures were caused by hypoglycemia or not. Most states will withold driving until the person has no loss of consciousness episodes for 6 mos to one year, depending on the state.

Denial is a major problem with new-onset epilepsy, particularly when it comes to taking medication or following restrictions. Perhaps you might suggest she contact her local epilepsy association for counseling or involvment in support groups to help her better understand her illness.

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