Epilepsy

Panic Disorder - Epilepsy Factor

RMA definition

Epilepsy means a chronic neurological disorder characterised by two or more epileptic seizures.  Note Establishing a diagnosis of epilepsy can be complex and you should refer to the diagnostic protocol for epilepsy for further information.

General information about epilepsy

Epilepsy consists of chronic, recurrent, paroxysmal changes in function of the nervous system caused by abnormalities in the electrical activity in the brain.  Each episode of neurological dysfunction is termed a seizure.  A seizure may be partial, involving only isolated muscle groups and may be accompanied by alteration of consciousness or awareness of the environment, or generalised and accompanied by severe muscle contractions, loss of consciousness and incontinence.  Status epilepticus is associated with a high mortality rate.

Symptoms and signs of epilepsy

• The most common form of attacks begin with loss of consciousness and motor control, and jerking of all extremities.  Urinary and faecal incontinence may occur.  The attack may last 2 to 5 minutes.  It may be preceded by a mood change, and may be followed by deep sleep, headache, or muscle soreness.
• When a diagnosis of epilepsy has been made the evidence may mention such medication as Dilantin, Tegretol and Epilim.  There may be use of the term "grand mal" where generalised seizures occur.
• "Petit mal" is a variety of epilepsy not associated with convulsive muscle activity.  There may be momentary lapses of thought activity or awareness lasting from a few seconds to a minute or so, followed by rapid and complete return to normal.  Drugs such as Zarontin and Epilim may be mentioned.

Establishing the clinical onset of epilepsy

If there have been at least two seizures, more than 24 hours apart, which were not due to an acute (short term) precipitating cause, the clinical onset of epilepsy is when the first of those seizures occurred, even if there was a gap of decades between them.  However, a diagnosis of epilepsy can only be made when the second of those seizures occurred.

If a person had epilepsy he or she would have needed significant medical attention at that time.  Status epilepticus would be considered to be a medical emergency and possibly life-threatening.  Such medical treatment would normally be recorded in doctors' notes and/or hospital records.  However, if these records have been destroyed or can no longer be obtained and there is a reliable history of epilepsy at a particular time, this generally will be accepted, unless there is contradictory evidence.  Obtain medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to epilepsy rather than to some other condition.

LAST REVIEWED FOR CCPS 21 MAY 2010.

PRELIMINARY QUESTIONS [41392]

38868 there is some evidence that epilepsy may be a factor in the development or worsening of the condition under consideration.

41414 the veteran has had epilepsy at some time.

38870  the veteran has established the causal connection between epilepsy and VEA service for the condition under consideration.

38877 the veteran had epilepsy at the time of the clinical onset of the condition under consideration.

38871   the veteran has established the causal connection between epilepsy and VEA service for the clinical onset of the condition under consideration.

38873  the veteran has established the causal connection between epilepsy and operational service for the clinical onset of the condition under consideration.

or

38874  the veteran has established the causal connection between epilepsy and eligible service for the clinical onset of the condition under consideration.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

38878 the veteran had epilepsy at the time of the clinical worsening of the condition under consideration.

38872   the veteran has established the causal connection between epilepsy and VEA service for the clinical worsening of the condition under consideration.

38875  the veteran has established the causal connection between epilepsy and operational service for the clinical worsening of the condition under consideration.

or

38876  the veteran has established the causal connection between epilepsy and eligible service for the clinical worsening of the condition under consideration.

CLINICAL ONSET AND OPERATIONAL SERVICE [38873]

38879  the veteran's epilepsy is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [38874]

38880  the veteran's epilepsy is causally related to eligible service.

CLINICAL WORSENING AND OPERATIONAL SERVICE [38875]

38879  the veteran's epilepsy is causally related to operational service.

38881 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the veteran's epilepsy is causally related.

CLINICAL WORSENING AND ELIGIBLE SERVICE [38876]

38880  the veteran's epilepsy is causally related to eligible service.

38882 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the veteran's epilepsy is causally related.