6  Seizure Precautions

Living with epilepsy does not mean living in a bubble. For most people, the goal is a full, active life with some thoughtful adjustments to reduce the small but real risks that come with unpredictable seizures. This chapter outlines practical safety considerations across common areas of daily life.

The right level of precaution depends on how well seizures are controlled, what type of seizures a person has, and how much warning (if any) they get before a seizure begins. Your neurologist is the best person to help calibrate what makes sense for your specific situation.

6.1 Water Safety

Drowning is one of the most serious risks associated with epilepsy, and it can occur in surprisingly shallow water. A seizure during bathing or swimming can cause loss of muscle control and consciousness within seconds.

Bathing

  • Showers are generally safer than baths for people with uncontrolled seizures.
  • If a bath is preferred, keep the water level low and never lock the bathroom door.
  • A caregiver should remain nearby and check in regularly. For young children or those with frequent seizures, direct supervision in the bathroom is recommended.

Swimming

  • Always swim with a companion who knows about the epilepsy and knows how to respond to a seizure.
  • Inform a lifeguard before entering the water.

6.2 Height and Falls

Falls during a seizure can cause serious injuries, particularly if a person loses consciousness or has sudden convulsive movements.

  • Climbing - ladders, scaffolding, and climbing walls should be approached with caution or avoided if seizures are not well controlled.
  • Elevated work surfaces - people who work at height (rooftops, platforms) should discuss safety accommodations with their employer and neurologist.

6.3 Driving

Driving is one of the most significant practical concerns for people with epilepsy. A seizure at the wheel can be fatal to the driver, passengers, and others on the road.

Every province and state has laws governing driving and epilepsy. These vary but most require a seizure-free period, typically 6 to 12 months, before a person may drive.

6.4 Sleep

Sleep deprivation is a well-known seizure trigger for many people with epilepsy.

  • Aim for consistent sleep and wake times.
  • Avoid staying up for prolonged periods of time
  • If a teenager with epilepsy is staying overnight at a friend’s house, it is worth planning ahead so they get adequate sleep.

6.5 School and Work

Children with epilepsy are entitled to appropriate supports at school. A seizure action plan, completed by your neurologist and shared with the school, is an essential document. It tells teachers and staff what to do during a seizure, when to call an ambulance, and what medications the child takes.

Adults with epilepsy may need to discuss accommodations with their employer, particularly if their job involves driving, operating heavy machinery, or working at height.

6.6 Alcohol and Recreational Substances

Alcohol can lower the seizure threshold and interact with antiseizure medications. Moderate consumption may be acceptable for some people with well-controlled epilepsy, but binge drinking should be avoided. Alcohol withdrawal is also a significant seizure trigger.

Cannabis, stimulants, and other recreational substances each carry their own risks and interactions with antiseizure medications. Discuss any substance use honestly with your neurologist.

6.7 Medications and Sick Days

Illness with fever can increase seizure frequency in some people. Missing doses of antiseizure medication is a common reasons for breakthrough seizures.

  • Keep a supply of medications at school or work in case a dose is missed.
  • Use pill organizers or phone alarms to support consistent dosing.
  • If vomiting occurs after a dose and medication is not absorbed, you can likely re-adminster that dose but contact your neurologist for specific instructions
  • Carry a list of current medications at all times, especially when traveling.

6.8 Medical ID

A medical ID bracelet or card can be life-saving if a seizure occurs in a public place where no one knows the person’s history. It helps emergency responders understand what they are dealing with and avoid unnecessary interventions.

Medical ID bracelets are available from many suppliers and can include a diagnosis, key medications, and emergency contacts. Several apps and digital wallet cards also serve this purpose.