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Epilepsy is a condition that causes recurring, unprovoked seizures. The National Institute of Neurological Disorders and Stroke estimates that 2.3 million adults and over 450,000 children in the United States have epilepsy.

Some types of health conditions can put a person at an increased risks with COVID-19, the illness caused by the novel coronavirus. Evidence is limited, but it currently doesn’t look like epilepsy raises your risk of contracting COVID-19. It also doesn’t affect the severity of the disease if you do get it.

In this article, we’ll discuss what we know so far about epilepsy and COVID-19, and go over the precautions to take during the pandemic.

Now let’s dig deeper into what we know about how COVID-19 impacts people with epilepsy. Typically, this involves two questions:

  1. Does having epilepsy increase your risk of contracting COVID-19?
  2. Does having epilepsy raise your risk of becoming severely ill from COVID-19?

Currently, the Centers for Disease Control and Prevention (CDC) lists “dementia and other neurological conditions” as a risk factor for severe COVID-19. But research on the specific impact of COVID-19 on those with epilepsy is limited and sometimes conflicting.

Risk of contracting COVID-19 if you have epilepsy

Though the research on this subject is limited, there have been some studies so far on a possible link between epilepsy and COVID-19.

A 2021 study surveyed 358 people, of which 154 had epilepsy. In total, 11 percent of all respondents had a history of COVID-19. Having epilepsy wasn’t found to be associated with an increased risk of contracting COVID-19 in this cohort.

A 2020 study assessed 1,537 individuals with COVID-19. A total of 21 people (1.3 percent) had previously been diagnosed with epilepsy and were taking medications to manage it, or reported having had at least one seizure in the past year.

Researchers found that the incidence of COVID-19 was higher in individuals with active epilepsy than in the general population. But a main drawback of this study is that only about 43 percent of those with active epilepsy had COVID-19 that was confirmed with a COVID-19 test.

A 2021 study surveyed 252 people with epilepsy. Researchers observed that the percentage of people with confirmed COVID-19 was higher than the general population at the time. But researchers weren’t able to identify specific risk factors for contracting COVID-19 in this cohort.

Similar to the 2020 study discussed above, this study also included individuals with probable COVID-19 not confirmed by a COVID-19 test.

Risk of severe illness or mortality

Another area of research is the severity of illness when COVID-19 is contracted by people with epilepsy. The 2020 study discussed above that assessed 1,537 individuals with COVID-19 found the following:

  • In individuals with epilepsy and confirmed COVID-19, there was no difference in mortality rate compared to the general population.
  • In individuals with active epilepsy who were hospitalized, having high blood pressure was associated with higher mortality.
  • Another model showed that people with epilepsy experienced a mortality rate that increase with older age.

A 2021 review of studies assessed COVID-19 severity in people with different neurological disorders. The review included a total of 26 articles. It found that, of the 2,168 individuals included across the different studies, 98 had epilepsy.

Of these 98 people, 10 (10.2 percent) experienced severe COVID-19. But this percentage was lower than individuals with other neurological conditions, including:

The 2021 study above that surveyed 252 people with epilepsy found that all individuals with confirmed or probable COVID-19 had mild to moderate illness with symptoms lasting between 7 and 21 days.

Other ways COVID-19 may affect those with epilepsy

Some research shows that the COVID-19 pandemic itself can impact quality of life in people with epilepsy in additional ways.

A 2021 study surveyed 151 people with epilepsy. Some of the most common problems reported during the pandemic included:

  • increased stress
  • feelings of anxiety or depression
  • trouble sleeping

A total of 35 respondents reported worsening seizure during the pandemic without having COVID-19. The explanation for this often had to do with increased pandemic-related stresses, including:

  • being retired or unemployed
  • experiencing a lack of sleep
  • fears of contracting COVID-19
  • concerns about shortages of antiepileptic medications
  • worries over the potential for worsening seizures

A total of 8 respondents contracted COVID-19. Only one reported a mild worsening of their seizures while they were ill.

In many states, having a neurological condition like epilepsy was a qualification to be vaccinated earlier than the general population. At the time of this writing, COVID-19 vaccines are available to all individuals age 12 and older.

The COVID-19 vaccines that are currently authorized in the United States are the:

Are the COVID-19 vaccines safe for people with epilepsy?

The CDC notes that people with underlying health conditions may safely receive a COVID-19 vaccine. An exception is if you’ve had a serious allergic reaction to any of the ingredients in the COVID-19 vaccine or to a previous dose of the vaccine.

There’s currently no evidence that people with epilepsy are at an increased risk of adverse effects from the COVID-19 vaccine.

A 2021 article reviewed the large-scale clinical trials of different COVID-19 vaccines. It notes that no serious neurological side effects were attributed to vaccination with any of the three COVID-19 vaccines currently authorized in the United States.

The Epilepsy Foundation notes that fever, a common side effect of the COVID-19 vaccines, may temporarily lower seizure thresholds in some people. In rare cases, this may result in a seizure.

If you’re concerned about fever-related seizures after vaccination, be sure to speak with a healthcare professional. They can advise you on how to lower your risk of experiencing a seizure due to fever after your vaccination.

What are the benefits of COVID-19 vaccination?

Getting vaccinated has many benefits for people with and without epilepsy, like:

  • Protecting yourself. COVID-19 vaccines are effective at preventing COVID-19 and its associated complications. If you receive a vaccination and do contract COVID-19, it’s likely that your illness will be milder.
  • Protecting others. Some people can’t receive a COVID-19 vaccine. By getting your vaccine, you’re helping to protect these individuals from being exposed to COVID-19 and potentially becoming seriously ill.
  • Stopping the spread. As the amount of people who receive a COVID-19 vaccine increases, the spread of the novel coronavirus within communities will begin to slow.
  • Returning to normal. Individuals who are fully vaccinated can begin doing some things that they had stopped doing during the pandemic, like attending gatherings and going places that no longer require a mask.

If you have epilepsy, is one COVID-19 vaccine recommended over the others?

The CDC doesn’t recommend one of the COVID-19 vaccines over the others. But you can choose which type of vaccine that you receive.

The Johnson and Johnson COVID-19 vaccine is associated with a heightened risk of blood clots. The CDC says this is most common in women between the ages of 18 and 48. But this side effect is very rare, happening in about 7 per 1 million women in this age group.

These blood clots can affect the large blood vessels in the brain, and in some cases, they may cause seizures. But these seizures aren’t the same as those that occur in epilepsy.

If you’re concerned about the risk of very rare blood clots associated with the Johnson and Johnson vaccine, you can choose to receive either the Pfizer-BioNTech or Moderna vaccines, which aren’t associated with this side effect.

People with epilepsy can take the following steps and precautions during the COVID-19 pandemic.

Follow your treatment plan

It’s important that you continue to follow your treatment plan during the pandemic. Your treatment plan may include:

Keep a 90-day supply of medications

If possible, it’s a good idea to have a 90-day supply of both prescription and nonprescription medications on hand. That way, if there’s a temporary supply issue or you have to self-isolate, you’ll be covered for several weeks.

Continue to take steps to prevent COVID-19

It’s important to continue to take COVID-19 prevention steps, especially if you’re not yet fully vaccinated. These include:

  • washing your hands frequently, particularly after being out in public
  • wearing a mask that covers your mouth and nose when you’re out in public or around others outside of your household
  • keeping a distance of 6 feet between yourself and others outside of your household
  • regularly cleaning and disinfecting high-touch surfaces in your home
  • avoiding crowded or poorly ventilated areas

Manage stress

The pandemic has been stressful for many people around the world. Because stress can trigger seizures in some individuals with epilepsy, try to take steps to reduce it. Some suggestions for stress reduction include:

  • getting regular exercise
  • trying out yoga or meditation
  • doing a hobby that you enjoy
  • curling up with a book
  • listening to music that you find soothing
  • safely visiting with family and friends

If you notice that you’re developing signs of increased anxiety or depression, don’t hesitate to reach out to your doctor or another medical professional. They can recommend some mental health resources that can help.

Have an emergency care plan

Make sure that you have a well-defined emergency plan during the pandemic. This includes when and how to take rescue medications, like benzodiazepines. It also means knowing when to seek emergency medical care.

If you don’t have a plan in place already, your doctor can work with you to help develop one. Be sure that your family and caregivers also have a clear understanding of it.

Seek care when necessary

Plan to keep up with your regular medical appointments. Many doctors are offering telehealth consultations during the pandemic.

Additionally, don’t hesitate to seek care for health emergencies, regardless of if they’re related to your epilepsy or not. Urgent care facilities and emergency rooms have put infection control measures in place for your protection.

If you have epilepsy and contract COVID-19, contact your doctor to let them know. Every individual with epilepsy is different and has different needs. Your doctor can advise you on what specific steps to take during your recovery.

In the general population, COVID-19 illness is often mild to moderate, and most people can recover at home. As discussed above, the available research indicates that this may also be the case in many individuals with epilepsy.

While recovering from COVID-19, aim to get rest, stay hydrated, and use over-the-counter medications for symptoms like fever and discomfort. Never stop taking your antiepileptic medications unless instructed to do so by your doctor.

Worsening seizures in people with epilepsy and COVID-19 have been reported, but this seems to be rare. If you develop worsening seizures due to COVID-19, contact your doctor for advice and next steps.