A seizure occurs when a group of brain cells- which normally discharge in a choice or random manner – suddenly discharge together in rhythmic bursts. Epileptic seizures have many causes, including a genetic predisposition for certain types of seizures, stroke, brain tumors, head trauma, alcohol or drug withdrawal, repeated episodes of metabolic insults, such as hypoglycemia. Epilepsy is a medical disorder marked by recurrent, unprovoked seizures. Therefore, repeated seizures with an identified provocation (eg, alcohol withdrawal) do not constitute epilepsy. Epilepsy is a generic term for a variety of seizure disorders. Seizures are a symptom of epilepsy. Epilepsy describes a state in which a group of abnormal brain cells, scar tissue, malformation or other underlying condition makes the brain susceptible to periodic or recurring rhythmic bursts of electrical energy.
Both seizure disorder and epilepsy can be the basis of social security disability benefits. Here are the top 5 most important factors to consider:
Proper Epilepsy/Seizure Disorder Diagnosis is Critical
EEG Video Monitoring
Seizure Triggers are Imporant: Some More than Others
Seizure Frequency and Duration is Everything.
Medical Compliance: Proof of Therapeudic level of Antiseizure Medications
Approximately 60% of people who develop epilepsy may get control of their seizures easily with medicine. Therefore in assessing whether a seizure disorder is disabling under the Social Security Act, the decision-maker or Administrative Law Judge will carefully review lab work results in the medical record for evidence that antiseizure medicaion blood levels are at a “therapeudic” level. So for example if a social security disability applicant claiming seizures keep her from working has been prescribed Depakote, but lab results do not reflect a therapeudic level of Depakote in the blood stream, a significant question is created: is the patient taking her Depakote as directed? Failing to take prescribed anticonvulsant medication is a sure way to lose a social security disability claim based upon seizure activity
Yet the absence of a therapeudic anticonvulsant medication level is not always the result of patient non-compliance: individual differences in metabolism can account for sub-therapeudic anticonvulsant medication blood levels dispite medical compliance. Doctors will in all likelihood increase the prescribed dose, and the ALJ will carefully look for the point in the medical record where anticonvulsant blood levels reflect a therapeudic level. The key question social security will ask is this: what is the seizure frequency and duration when blood levels reflect therapeudic anticonvulsant blood levels?
5. Psychogenic non-epileptic or “Psuedoseizures” Require Unique Approach