disability

I have a mild form of epilepsy, probably juvenile myoclonic epilepsy (though I have only ever been diagnosed with “idiopathic epilepsy”). This manifests most prominently as myoclonic seizures, which entail brief, involuntary physical movements. In my case, they present as rapid upper body movements. These seizures also have absence seizure characteristics: I experience a brief (less than one second) disturbance or loss of consciousness. I also experience absence seizures without a physical component; in fact, the myoclonic seizures are probably just severe versions of these absence seizures.

I take lamotrigine daily for this condition, and it works well.

When you think of epilepsy, you may imagine someone shaking uncontrollably on the ground, possibly accompanied by flashing lights. I have only ever had two generalized tonic-clonic seizures, and I am unlikely to have any more while medicated. I am also not photosensitive (only a small minority of people with epilepsy are). My most important trigger is lack of sleep. I need more sleep than most people, defaulting to around 9 hours per day in the absence of any other pressures. This is probably not a coincidence: if I miss a medication dose, I sleep longer and wake up feeling exhausted. Also, if I am in a certain mental state (difficult to describe), I may be triggered by attempting to quickly make decisions or perform calculations. This usually happens while I am playing a game (even a board game or a card game). This is a kind of reflex seizure; the specific condition is called “thinking epilepsy”, and is apparently quite rare.

I have never had a license to drive, and I am not sure whether I would be legally allowed to if I tried. Most states in the United States require that a patient be seizure-free for a period of several months before driving; whether I meet this criterion depends on the definition of “seizure”. If it includes only tonic-clonic seizures, then I am certainly eligible. If not, then I will probably never be eligible. (I say “probably” because I do not track my small absence seizures closely, and I am not sure I could ever do so—can you be certain that you have not had an extremely brief interruption of consciousness in the last few months?) This is just one reason that I like walkable cities.

The Wikipedia article for juvenile myoclonic epilepsy mentions that it is associated with an elevated rate of psychiatric disorders. Without going into too much detail, I am a data point that agrees with the overall trend. There is no “myself-without-epilepsy”; there is only myself, with epilepsy.

(In the unlikely event that anyone reading this happens to ever see me have a tonic-clonic seizure: please do not call an ambulance unless I am in a country with socialized healthcare! The seizure will probably end before the ambulance arrives, and there isn't much that doctors can do for a post-ictal patient. Only call an ambulance if the seizure lasts longer than a few minutes, because then there is a risk of status epilepticus.)