Dating someone with epilepsy

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These other treatments include at least a trial of two or three medications. Or because they want to pursue relationships with those who have disabilities, or perhaps a specific condition such as epilepsy? An example of this type is the , which presents as a decreased level of consciousness and usually lasts about 10 seconds. It is important to recognize mood problems because effective treatment is available that can improve your quality of life.

For anyone who has experienced rejection because of epilepsy, the mere thought of dating can bring on feelings of hurt and ring. Main article: The most common type 60% of seizures are. Erhalten Sie personalisierte Werbung von Partnern unseres Vertrauens Dies bedeutet nicht mehr, sondern personalisierte Werbung. It's unusual for him to say that he only has a 15% chance of having kids -- that would be sin to determine unless he's had an extensive work-up from a hormone specialist. This is completely understandable. Confusion may last longer than the seizure itself and may be hazardous. Just got done reading your book, Rag. Viewing problems with sex as a personal dating someone with epilepsy or weakness may put more ring on you, and stop you seeking help for the problem. For an in-depth look at the impact of epilepsy on your mood and memory, watch this video from the 2015 Lehigh Valley Epilepsy Education Exchange by Dr. That's basically what I dating someone with epilepsy getting at. People of the time would con on their chest believing that this would keep the problem from affecting them. In 2018 an advisory panel of the FDA supported approving this product for and.

I told him how drs always told me I could never have kids, and was for sure I wasnt pregnant. Ethosuximide is specific for these channels and thus it is not effective for treating other types of seizure. It's unusual for him to say that he only has a 15% chance of having kids -- that would be tough to determine unless he's had an extensive work-up from a hormone specialist. Depression is a medical illness that affects the body, mood and thoughts.

Choose region and then country - Hey psychological impact can clarity have.

For the journal, see. For the novel, see. Epileptic seizures are episodes that can vary from brief and nearly undetectable periods to long periods of vigorous shaking. These episodes can result in physical injuries, including occasionally. In epilepsy, seizures tend to recur and, as a rule, have no immediate underlying cause. Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy may be treated differently in various areas of the world and experience varying degrees of due to their condition. The cause of most cases of epilepsy is unknown. Some cases occur as the result of , , , infections of the brain, and through a process known as. Known are directly linked to a small proportion of cases. Epileptic seizures are the result of excessive and abnormal activity in the. The diagnosis involves ruling out other conditions that might cause similar symptoms, such as , and determining if another cause of seizures is present, such as or problems. This may be partly done by and performing. Epilepsy can often be confirmed with an EEG , but a normal test does not rule out the condition. Epilepsy that occurs as a result of other issues may be preventable. Seizures are controllable with medication in about 70% of cases. Inexpensive options are often available. In those whose seizures do not respond to medication, , or dietary changes may then be considered. Not all cases of epilepsy are lifelong, and many people improve to the point that treatment is no longer needed. As of 2015, about 39 million people have epilepsy. Nearly 80% of cases occur in the. In 2015, it resulted in 125,000 deaths up from 112,000 deaths in 1990. Epilepsy is more common in older people. In the developed world, onset of new cases occurs most frequently in babies and the elderly. In the developing world, onset is more common in older children and young adults, due to differences in the frequency of the underlying causes. About 5—10% of people will have an unprovoked seizure by the age of 80, and the chance of experiencing a second seizure is between 40 and 50%. In many areas of the world, those with epilepsy either have restrictions placed on their ability to drive or are not permitted to drive until they are free of seizures for a specific length of time. Main article: The most common type 60% of seizures are. Of these, one-third begin as from the start, affecting both hemispheres of the brain. Two-thirds begin as which affect one hemisphere of the brain which may then progress to. The remaining 40% of seizures are non-convulsive. An example of this type is the , which presents as a decreased level of consciousness and usually lasts about 10 seconds. They include sensory visual, hearing, or smell , psychic, autonomic, and motor phenomena. Jerking activity may start in a specific muscle group and spread to surrounding muscle groups in which case it is known as a. There are six main types of generalized seizures: , , , , and. They all involve loss of consciousness and typically happen without warning. Tonic-clonic seizures occur with a contraction of the limbs followed by their extension along with arching of the back which lasts 10—30 seconds the tonic phase. A cry may be heard due to contraction of the chest muscles, followed by a shaking of the limbs in unison clonic phase. Tonic seizures produce constant contractions of the muscles. A person often turns blue as breathing is stopped. In clonic seizures there is shaking of the limbs in unison. The tongue may be bitten at either the tip or on the sides during a seizure. In , bites to the sides are more common. Tongue bites are also relatively common in. Myoclonic seizures involve spasms of muscles in either a few areas or all over. Absence seizures can be subtle with only a slight turn of the head or eye blinking. The person does not fall over and returns to normal right after it ends. Atonic seizures involve the loss of muscle activity for greater than one second. This typically occurs on both sides of the body. About 6% of those with epilepsy have seizures that are often triggered by specific events and are known as. Those with have seizures that are only triggered by specific stimuli. Common triggers include flashing lights and sudden noises. In certain types of epilepsy, seizures happen more often during , and in other types they occur almost only when sleeping. Post-ictal After the active portion of a seizure the state there is typically a period of recovery during which there is confusion, referred to as the period before a normal returns. It usually lasts 3 to 15 minutes but may last for hours. Other common symptoms include feeling tired, , difficulty speaking, and abnormal behavior. Often people do not remember what happened during this time. Localized weakness, known as , may also occur after a focal seizure. When it occurs it typically lasts for seconds to minutes but may rarely last for a day or two. Psychosocial Epilepsy can have adverse effects on social and psychological well-being. These effects may include social isolation, stigmatization, or disability. They may result in lower educational achievement and worse employment outcomes. Learning disabilities are common in those with the condition, and especially among. The stigma of epilepsy can also affect the families of those with the disorder. Certain disorders occur more often in people with epilepsy, depending partly on the epilepsy syndrome present. These include , , OCD , and. ADHD and epilepsy have significant consequences on a child's behavioral, learning, and social development. Epilepsy is also more common in children with. See also: Epilepsy can have both genetic and acquired causes, with interaction of these factors in many cases. Established acquired causes include serious brain trauma, stroke, tumours and problems in the brain as a result of a previous. In about 60% of cases the cause is unknown. Epilepsies caused by , , or conditions are more common among younger people, while and are more likely in older people. Seizures may also occur as a consequence of other health problems; if they occur right around a specific cause, such as a stroke, head injury, toxic ingestion or metabolic problem, they are known as and are in the broader classification of rather than epilepsy itself. Genetics Genetics is believed to be involved in the majority of cases, either directly or indirectly. Some epilepsies are due to a single gene defect 1—2% ; most are due to the interaction of multiple genes and environmental factors. Each of the single gene defects is rare, with more than 200 in all described. Most genes involved affect , either directly or indirectly. These include genes for themselves, , , and. In , if one is affected there is a 50—60% chance that the other will also be affected. In non-identical twins the risk is 15%. These risks are greater in those with generalized rather than focal seizures. If both twins are affected, most of the time they have the same epileptic syndrome 70—90%. Other close relatives of a person with epilepsy have a risk five times that of the general population. Between 1 and 10% of those with and 90% of those with have epilepsy. Acquired Epilepsy may occur as a result of a number of other conditions including tumors, , head trauma, previous , genetic abnormalities, and as a result of brain damage around the time of birth. Of those with brain tumors, almost 30% have epilepsy, making them the cause of about 4% of cases. The risk is greatest for tumors in the and those that grow slowly. Other mass lesions such as and have risks as high as 40—60%. Of those who have had a stroke, 2—4% develop epilepsy. In the United Kingdom strokes account for 15% of cases and it is believed to be the cause in 30% of the elderly. Between 6 and 20% of epilepsy is believed to be due to head trauma. In those who have experienced a high-powered gunshot wound to the head, the risk is about 50%. Some evidence links epilepsy and and , while other evidence does not. There appears to be a specific syndrome which includes coeliac disease, epilepsy and calcifications in the brain. A 2012 review estimates that between 1% and 6% of people with epilepsy have CD while 1% of the general population has the condition. The risk of epilepsy following is less than 10%; that disease more commonly causes seizures during the infection itself. In the risk of a seizure is around 50% with a high risk of epilepsy following up to 25%. Infection with the , which can result in , is the cause of up to half of epilepsy cases in areas of the world where the parasite is common. Epilepsy may also occur after other brain infections such as , , and. Chronic alcohol use increases the risk of epilepsy: those who drink six per day have a two and a half fold increase in risk. Other risks include , , , and. Getting vaccinated does not increase the risk of epilepsy. People with have an increased risk of epilepsy, with half of people with and having the disease. Normally brain electrical activity is non-synchronous. Its activity is regulated by various factors both within the and the cellular environment. Factors within the neuron include the type, number and distribution of , changes to and changes of. Factors around the neuron include concentrations, and regulation of breakdown by. Epilepsy The exact mechanism of epilepsy is unknown, but a little is known about its cellular and network mechanisms. However, it is unknown under which circumstances the brain shifts into the activity of a seizure with its. In epilepsy, the resistance of excitatory neurons to fire during this period is decreased. This may occur due to changes in or inhibitory neurons not functioning properly. Another mechanism of epilepsy may be the up-regulation of excitatory circuits or down-regulation of inhibitory circuits following an injury to the brain. These secondary epilepsies occur through processes known as. Failure of the may also be a causal mechanism as it would allow substances in the blood to enter the brain. Seizures There is evidence that are usually not a random event. Seizures are often brought on by factors such as stress, alcohol abuse, flickering light, or a lack of sleep, among others. The term is used to indicate the amount of necessary to bring about a seizure. Seizure threshold is lowered in epilepsy. In epileptic seizures a group of neurons begin firing in an abnormal, excessive, and synchronized manner. This results in a wave of depolarization known as a. Normally, after an fires it becomes more resistant to firing for a period of time. This is due in part to the effect of inhibitory neurons, electrical changes within the excitatory neuron, and the negative effects of. Focal seizures begin in one while generalized seizures begin in both hemispheres. Some types of seizures may change brain structure, while others appear to have little effect. An can aid in locating the focus of the epileptic seizure. The diagnosis of epilepsy is typically made based on observation of the seizure onset and the underlying cause. An EEG to look for abnormal patterns of brain waves and or to look at the structure of the brain are also usually part of the workup. While figuring out a specific epileptic syndrome is often attempted, it is not always possible. The definition of epilepsy requires the occurrence of at least one epileptic seizure. In the definition, epilepsy is now called a disease, rather than a disorder. The definition is practical in nature and is designed for clinical use. Researchers, statistically-minded epidemiologists, and other specialized groups may choose to use the older definition or a definition of their own devising. The ILAE considers doing so is perfectly allowable, so long as it is clear what definition is being used. Classification In contrast to the which focuses on what happens during a seizure, the classification of epilepsies focuses on the underlying causes. When a person is admitted to hospital after an epileptic seizure the results preferably in the seizure itself being classified e. The name of the diagnosis finally made depends on the available diagnostic results and the applied definitions and classifications of seizures and epilepsies and its respective terminology. These features include the age that seizure begin, the seizure types, findings, among others. Identifying an epilepsy syndrome is useful as it helps determine the underlying causes as well as what should be tried. The ability to categorize a case of epilepsy into a specific syndrome occurs more often with children since the onset of seizures is commonly early. Less serious examples are 2. Severe syndromes with diffuse brain dysfunction caused, at least partly, by some aspect of epilepsy, are also referred to as epileptic encephalopathies. These are associated with frequent that are resistant to treatment and severe cognitive dysfunction, for instance and. Genetics is believed to play an important role in epilepsies by a number of mechanisms. Simple and complex modes of have been identified for some of them. However, extensive screening have failed to identify many single variants of large effect. More recent exome and genome sequencing studies have begun to reveal a number of de novo gene mutations that are responsible for some epileptic encephalopathies, including and and , , and. Syndromes in which causes are not clearly identified are difficult to match with categories of the current classification of epilepsy. Categorization for these cases was made somewhat arbitrarily. Some childhood epilepsy syndromes are included in the unknown cause category in which the cause is presumed genetic, for instance. Others are included in symptomatic despite a presumed genetic cause in at least in some cases , for instance. Clinical syndromes in which epilepsy is not the main feature e. Classification of epilepsies and particularly of epilepsy syndromes will change with advances in research. Tests An EEG can assist in showing brain activity suggestive of an increased risk of seizures. It is only recommended for those who are likely to have had an epileptic seizure on the basis of symptoms. In the diagnosis of epilepsy, electroencephalography may help distinguish the type of seizure or syndrome present. In children it is typically only needed after a second seizure. It cannot be used to rule out the diagnosis and may be falsely positive in those without the disease. In certain situations it may be useful to perform the EEG while the affected individual is sleeping or sleep deprived. Diagnostic imaging by and is recommended after a first non-febrile seizure to detect structural problems in and around the brain. MRI is generally a better imaging test except when bleeding is suspected, for which CT is more sensitive and more easily available. If someone attends the emergency room with a seizure but returns to normal quickly, imaging tests may be done at a later point. If a person has a previous diagnosis of epilepsy with previous imaging, repeating the imaging is usually not needed even if there are subsequent seizures. For adults, the testing of electrolyte, and calcium levels is important to rule out problems with these as causes. An can rule out problems with the rhythm of the heart. A lumbar puncture may be useful to diagnose a infection but is not routinely needed. In children additional tests may be required such as urine biochemistry and blood testing looking for. A high blood level within the first 20 minutes following a seizure may be useful to help confirm an epileptic seizure as opposed to. Serum prolactin level is less useful for detecting focal seizures. If it is normal an epileptic seizure is still possible and a serum prolactin does not separate epileptic seizures from syncope. It is not recommended as a routine part of the diagnosis of epilepsy. Differential diagnosis Diagnosis of epilepsy can be difficult. A number of other conditions may present very similar signs and symptoms to seizures, including , , , , and PNES. In particular a can be accompanied by a short episode of convulsions. Attacks of the movement disorder may be taken for epileptic seizures. The cause of a can be, among many others, an. Children may have behaviors that are easily mistaken for epileptic seizures but are not. These include , , , and. Misdiagnosis is frequent occurring in about 5 to 30% of cases. Different studies showed that in many cases seizure-like attacks in apparent treatment-resistant epilepsy have a cardiovascular cause. Approximately 20% of the people seen at epilepsy clinics have PNES and of those who have PNES about 10% also have epilepsy; separating the two based on the seizure episode alone without further testing is often difficult. Supporting people's of their condition may be useful. In drug-resistant cases different may be looked at including a special diet, the implantation of a , or. First aid Rolling a person with an active tonic-clonic seizure onto their side and into the helps prevent fluids from getting into the lungs. Putting fingers, a bite block or tongue depressor in the mouth is not recommended as it might make the person or result in the rescuer being bitten. Efforts should be taken to prevent further self-injury. If a seizure lasts longer than 5 minutes or if there are more than two seizures in an hour without a return to a normal level of consciousness between them, it is considered a known as. This may require ; a may be useful for this. At home the recommended initial medication for seizure of a long duration is placed in the mouth. In hospital, intravenous is preferred. If two doses of are not effective, other medications such as are recommended. Convulsive status epilepticus that does not respond to initial treatment typically requires admission to the and treatment with stronger agents such as or. Medications Anticonvulsants The mainstay treatment of epilepsy is medications, possibly for the person's entire life. The choice of anticonvulsant is based on seizure type, epilepsy syndrome, other medications used, other health problems, and the person's age and lifestyle. A single medication is recommended initially; if this is not effective, switching to a single other medication is recommended. Two medications at once is recommended only if a single medication does not work. In about half, the first agent is effective; a second single agent helps in about 13% and a third or two agents at the same time may help an additional 4%. About 30% of people continue to have seizures despite anticonvulsant treatment. There are a number of medications available including , and. Low-quality evidence suggests that phenytoin, carbamazepine, and valproate may be equally effective in both focal and generalized seizures. In the United Kingdom, carbamazepine or are recommended as first-line treatment for focal seizures, with and valproate as second-line due to issues of cost and side effects. Valproate is recommended first-line for generalized seizures with lamotrigine being second-line. In those with absence seizures, or valproate are recommended; valproate is particularly effective in myoclonic seizures and tonic or atonic seizures. If seizures are well-controlled on a particular treatment, it is not usually necessary to routinely check the medication levels in the blood. The gives it a first-line recommendation in the developing world and it is commonly used there. Access however may be difficult as some countries label it as a. Adverse effects from medications are reported in 10 to 90% of people, depending on how and from whom the data is collected. Most adverse effects are dose-related and mild. Some examples include mood changes, sleepiness, or an unsteadiness in gait. Certain medications have side effects that are not related to dose such as rashes, liver toxicity, or. Up to a quarter of people stop treatment due to adverse effects. Some medications are associated with when used in pregnancy. Many of the common used medications, such as valproate, phenytoin, carbamazepine, phenobarbitol, and gabapentin have been reported to cause increased risk of birth defects, especially when used during the. Despite this, treatment is often continued once effective, because the risk of untreated epilepsy is believed to be greater than the risk of the medications. Among the antiepileptic medications, levetiracetam and lamotrigine seem to carry the lowest risk of causing birth defects. Slowly stopping medications may be reasonable in some people who do not have a seizure for two to four years; however, around a third of people have a recurrence, most often during the first six months. Stopping is possible in about 70% of children and 60% of adults. Surgery may be an option for people with focal seizures that remain a problem despite other treatments. These other treatments include at least a trial of two or three medications. The goal of surgery is total control of seizures and this may be achieved in 60—70% of cases. Common procedures include cutting out the via an anterior temporal lobe resection, removal of tumors, and removing parts of the. Some procedures such as a are attempted in an effort to decrease the number of seizures rather than cure the condition. Following surgery, medications may be slowly withdrawn in many cases. Three types have been shown to be effective in those who do not respond to medications: , , and. Diet A high-, , adequate- appears to decrease the number of seizures and eliminate seizures in some, however further research is necessary. It is a reasonable option in those who have epilepsy that is not improved with medications and for whom surgery is not an option. About 10% stay on the diet for a few years due to issues of effectiveness and tolerability. Side effects include stomach and intestinal problems in 30%, and there are long-term concerns about heart disease. Less radical diets are easier to tolerate and may be effective. It is unclear why this diet works. Exercise has been proposed as possibly useful for preventing seizures with some data to support this claim. In people with coeliac disease or non-celiac gluten sensitivity and occipital calcifications, a may decrease the frequency of seizures. Other Avoidance therapy consists of minimizing or eliminating triggers. For example, in those who are sensitive to light, using a small television, avoiding video games, or wearing dark glasses may be useful. Psychological methods should not, however, be used to replace medications. Some dogs, commonly referred to as , may help during or after a seizure. It is not clear if dogs have the ability to predict seizures before they occur. The trials were of poor methodological quality and it was not possible to draw any definitive conclusions. As an add-on therapy in those who are not well controlled with other medications appears to be useful in some children. In 2018 an advisory panel of the FDA supported approving this product for and. Of those with generalized seizures, more than 80% can be well controlled with medications while this is true in only 50% of people with focal seizures. One predictor of long-term outcome is the number of seizures that occur in the first six months. Other factors increasing the risk of a poor outcome include little response to the initial treatment, generalized seizures, a family history of epilepsy, psychiatric problems, and waves on the EEG representing generalized epileptiform activity. In the developing world, 75% of people are either untreated or not appropriately treated. In Africa, 90% do not get treatment. This is partly related to appropriate medications not being available or being too expensive. Mortality People with epilepsy are at an increased risk of death. This increase is between 1. Death from status epilepticus is primarily due to an underlying problem rather than missing doses of medications. The risk of suicide is between two and six times higher in those with epilepsy. The cause of this is unclear. SUDEP appears to be partly related to the frequency of generalized tonic-clonic seizures and accounts for about 15% of epilepsy related deaths. It is unclear how to decrease its risk. The greatest increase in mortality from epilepsy is among the elderly. Those with epilepsy due to an unknown cause have little increased risk. In the United Kingdom, it is estimated that 40—60% of deaths are possibly preventable. In the developing world, many deaths are due to untreated epilepsy leading to falls or status epilepticus. Epilepsy is one of the most common serious neurological disorders affecting about 39 million people as of 2015. It affects 1% of the population by age 20 and 3% of the population by age 75. It is more common in males than females with the overall difference being small. Most of those with the disorder 80% are in the. The estimated prevalence of active epilepsy as of 2012 is in the range 3—10 per 1,000, with active epilepsy defined as someone with epilepsy who has had a least one unprovoked seizure in the last five years. Epilepsy begins each year in 40—70 per 100,000 in developed countries and 80—140 per 100,000 in developing countries. Poverty is a risk and includes both being from a poor country and being poor relative to others within one's country. In the developed world epilepsy most commonly starts either in the young or in the old. In the developing world its onset is more common in older children and young adults due to the higher rates of trauma and infectious diseases. In developed countries the number of cases a year has decreased in children and increased among the elderly between the 1970s and 2003. This has been attributed partly to better survival following strokes in the elderly. Hippocrates, 17th century engraving by of an antique bust. The oldest medical records show that epilepsy has been affecting people at least since the beginning of recorded history. Throughout , the disease was thought to be a spiritual condition. The world's oldest description of an epileptic seizure comes from a text in a language used in ancient and was written around 2000 BC. The person described in the text was diagnosed as being under the influence of a moon god, and underwent an. Epileptic seizures are listed in the c. The oldest known detailed record of the disease itself is in the , a medical text from 1067—1046 BC. This text gives signs and symptoms, details treatment and likely outcomes, and describes many features of the different seizure types. As the Babylonians had no biomedical understanding of the nature of disease, they attributed the seizures to possession by evil spirits and called for treating the condition through spiritual means. Around 900 BC, described epilepsy as loss of consciousness; this definition was carried forward into the text of about 400 BC. The had contradictory views of the disease. They thought of epilepsy as a form of spiritual possession, but also associated the condition with genius and the divine. One of the names they gave to it was the sacred disease ἠ ἱερὰ νόσος. Epilepsy appears within Greek mythology: it is associated with the Moon goddesses and , who afflicted those who upset them. The Greeks thought that important figures such as and had the disease. The notable exception to this divine and spiritual view was that of the school of. In the fifth century BC, Hippocrates rejected the idea that the disease was caused by spirits. In his landmark work , he proposed that epilepsy was not divine in origin and instead was a medically treatable problem originating in the brain. He accused those of attributing a sacred cause to the disease of spreading ignorance through a belief in superstitious magic. Hippocrates proposed that was important as a cause, described worse outcomes if the disease presents at an early age, and made note of the physical characteristics as well as the social shame associated with it. Instead of referring to it as the sacred disease, he used the term great disease, giving rise to the modern term grand mal, used for tonic—clonic seizures. Despite his work detailing the physical origins of the disease, his view was not accepted at the time. Evil spirits continued to be blamed until at least the 17th century. In people did not eat or drink with the same pottery as that used by someone who was affected. People of the time would spit on their chest believing that this would keep the problem from affecting them. According to and other ancient physicians, in order to detect epilepsy, it was common to light a piece of , whose smoke would trigger the seizure. Occasionally a spinning was used, perhaps a reference to. In most cultures, persons with epilepsy have been stigmatized, shunned, or even imprisoned; in the , the birthplace of modern neurology, found people with epilepsy side-by-side with the mentally ill, those with chronic , and the criminally insane. In , epilepsy was known as the morbus comitialis 'disease of the assembly hall' and was seen as a curse from the gods. In northern Italy, epilepsy was once traditionally known as Saint Valentine's malady. In the mid-1800s, the first effective anti-seizure medication, , was introduced. The first modern treatment, , was developed in 1912, with phenytoin coming into use in 1938. See also: Stigma is commonly experienced, around the world, by those with epilepsy. It can affect people economically, socially and culturally. In India and China, epilepsy may be used as justification to deny marriage. People in some areas still believe those with epilepsy to be. In parts of Africa, such as and , epilepsy is incorrectly claimed to be associated with possession by evil spirits, witchcraft, or poisoning and is believed by many to be. Before 1971 in the United Kingdom, epilepsy was considered grounds for the annulment of marriage. The stigma may result in some people with epilepsy denying that they have ever had seizures. Economics Seizures result in direct economic costs of about one billion dollars in the United States. Epilepsy resulted in economic costs in Europe of around 15. In India epilepsy is estimated to result in costs of 1. It is the cause of about 1% of emergency department visits 2% for emergency departments for children in the United States. Vehicles See also: Those with epilepsy are at about twice the risk of being involved in a and thus in many areas of the world are not allowed to drive or only able to drive if certain conditions are met. In some places physicians are required by law to report if a person has had a seizure to the licensing body while in others the requirement is only that they encourage the person in question to report it themselves. Countries that require physician reporting include Sweden, Austria, Denmark and Spain. Countries that require the individual to report include the UK and New Zealand and the physician may report if they believe the individual has not already. In Canada, the United States and Australia the requirements around reporting vary by province or state. If seizures are well controlled most feel allowing driving is reasonable. The amount of time a person must be free from seizures before they can drive varies by country. Many countries require one to three years without seizures. In the United States the time needed without a seizure is determined by each state and is between three months and one year. Those with epilepsy or seizures are typically denied a pilot license. In Canada if an individual has had no more than one seizure, they may be considered after five years for a limited license if all other testing is normal. Those with febrile seizures and drug related seizures may also be considered. In the United States, the does not allow those with epilepsy to get a commercial pilot license. Rarely, exceptions can be made for persons who have had an isolated seizure or febrile seizures and have remained free of seizures into adulthood without medication. In the United Kingdom, a full requires the same standards as a professional driver's license. This requires a period of ten years without seizures while off medications. Those who do not meet this requirement may acquire a restricted license if free from seizures for five years. Support organizations There are organizations that provide support for people and families affected by epilepsy. The Out of the Shadows campaign, a joint effort by the World Health Organization, the and the , provides help internationally. The Joint Epilepsy Council serves the UK and Ireland. In the United States, the is a national organization that works to increase the acceptance of those with the disorder, their ability to function in society and to promote research for a cure. The Epilepsy Foundation, some hospitals, and some individuals also run support groups in the United States. Seizure prediction refers to attempts to forecast epileptic seizures based on the EEG before they occur. As of 2011, no effective mechanism to predict seizures has been developed. Medications that alter immune function, such as , are poorly supported by evidence. Noninvasive is, as of 2012, being compared to standard surgery for certain types of epilepsy. 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