Epilepsy and work: when the epilepsy should be considered incapacitating?

Abstract

Epilepsy is a brain disorder characterized predominantly by the disruption of normal brain function, recurrent and unpredictable, called the seizure. It is a variety of disorders re

flecting the basic brain dysfunction, which may result from different etiologias 1. It is one of the most common causes of brain disorders, affecting 50 million people around the world 2, and represents a personal and social burden. The possibility of physical injuries due seizures, social exclusion, stigma, and psychological disorders are some factors that also contribute to the compromised employment position of person with epilepsy; and their effects may be felt particularly hard in areas or times of high employment. A Brazilian study indicates that 36% of individuals with epilepsy are out of work due to illness or retired 4. But epilepsy is not always a condition of incapacity to work. Epilepsy is considered incapacitating when one or more life activity is substantially limited, among them the job. The objective of this study was to analyze the main factors of work absenteeism of people with epilepsy. The methodology applied was the literature review, in the main databases- “PUBMED” and “BIREME,” with access to other bases “LILACS”, “IBECS”, “MEDLINE”, “Cochrane Library” and “SciELO”. The statistical data provided by the Ministry of Social Security (MPS) were also analyzed. The search results showed that approximately 35% of the people with epilepsy suffer from some form of employment limitation by epilepsy or by the stigma. Brazilian social insurance (Ministry of Social Security) given 46,151 benefits in the last five years (average 9.230/year) due to epilepsy. Some factors influence on work capacity, including the frequency of seizures that can determine a drop of up to 70% of the waste labor, according to the European Baremos. The type of seizure also has significant influence, the crisis with loss of consciousness are associated with a 30% reduction in work productivity. The adverse events of antiepileptic drugs also compromise the labor capacity. People with epilepsy are more prone to unemployment, compared to people without epilepsy, although they are not more likely to accidents. Some professions are not indicated to people with epilepsy. The medical expert must evaluate the relationship between epilepsy and work activities. The conclusion of this study is that the medical history associated with the neurological examination, subsidized by reports of the treating physician are essential for the conclusion.