A headline topping the news earlier this week:
“Commerce Dept. says Sec. Bryson suffered seizure.”
The U.S. Commerce Department Secretary was involved in two motor vehicle crashes over last weekend. The accidents appear to be due to seizure activity. Secretary Bryson is 68 years-old.
This major news story brings up (at least) three important issues:
1) The highest achievers in our society can have seizures/epilepsy.
2) New onset-seizure activity in people over 60 years of age is associated with an increased risk of stroke (note- we have limited details on Secretary Bryson’s case).
3) A seizure while driving can be dangerous.
Important/famous people and epilepsy
I think it is very important to point out how epilepsy can affect a wide range of people in our society. Part of the stigma associated with epilepsy is the misconception by some that people with epilepsy cannot have high intelligence or great abilities. That is absolutely wrong! People with epilepsy are well known to be among the best and the brightest. Patients who have epilepsy are business leaders, musicians, doctors, lawyers, teachers and politicians. For example:
- Coach Kill is the University of Minnesota head football coach-his seizure activity on the sidelines of football games has been the subject of recent national news.
- Supreme Court Justice John Roberts has had documented seizure activity (Time Magazine, 2007).
Epilepsy is relatively common- affecting 1-2% of the population. Most people with epilepsy have well controlled seizures. Thus, people do not usually know who has seizures and are often not aware of the accomplishments of a person with epilepsy. I think that educating the general population about epilepsy is an important way to combat the stigma associated with the word “epilepsy.”
Dr. Robert Fisher, MD, PhD wrote an excellent review about famous people with seizures for Epilepsy.com (http://www.epilepsy.com/epilepsy/newsletter/Jan10_people). Did you know that the following people have been either suggested to have seizures or have clear documentation of epilepsy/seizures:
- Julius Caesar
- Vincent Van Gogh
- Leo Tolstoy
Epilepsy as a warning sign for stroke
Having the first seizure of a person’s life after the age of 60 years of age is a real shock to the patient. They have lived their whole life without having a seizure, so it can be quite a surprise. Not only is having a seizure a big deal for the patient, the patient also needs to contend with the following information:
- The onset of seizure activity after the age of 60 years is associated with a striking increase in the risk of stroke. The risk of stroke increases three-fold in patients who have their first seizure after the age of 60 years (Cleary et al, Late-onset Seizures as a Predictor of Subsequent Stroke, Lancet 2004;363:1184-1186).
The take home message of the study: if you have the first seizure of your life after the age of 60 years, you need to be evaluated for stroke risk factors and appropriate treatment given. The last thing a patient needs is a stroke! The seizure activity may be a warning sign that may help prevent the stroke.
Driving and seizures
Patients with epilepsy list driving restrictions as one of their top concerns (Krumholz A, Driving issues in epilepsy: past, present and future. Epilepsy Currents 2009;9:31-35). This of course makes sense- employment, taking care of family, seeing friends all are significantly limited if a person cannot drive. Although driving is extremely important for quality of life, driving with uncontrolled seizures that could impair a person’s driving ability is high risk behavior—for the patient and for others on the road. In the US, each state has its own driving rules as they pertain to epilepsy. The Epilepsy Foundation has a very useful website to search for driving information by state: (http://www.epilepsyfoundation.org/resources/drivingandtravel.cfm)
Several studies confirm that epilepsy poses some risk for motor vehicle accidents, but that risk seems small, especially compared to alcohol. For example, one study estimated that the percentage of fatal driver crashes caused by a seizure is only 0.2% as compared with 30% caused by alcohol (Sheth SG, Krauss G, Krumholz A. Neurology 2004;63:1002–1007). It has been reported that only 11% of all car crashes involving individuals with epilepsy are due to seizures. The majority of car accidents involving patients with epilepsy are not due to seizures—but rather due to driver error.
Latest Update: 6/13/2012