[Medical and social aspects of epilepsy (author's transl)].

A review of social aspects of epilepsy is given. Similar to the own experience the literature shows only little social prestige given to patients with epilepsy, an experience known from persons with psychiatric disorders. The prevalence rate for chronic epilepsy is 0.5%. So called genuine seizures decreased with diagnostic progress during the last years (about 50%). Lower social classes and negative social patterns are characteristic of employees with epileptic fits. Unemployed persons show normal social structure. A relation to social class and onset of epilepsy exists. Epileptics are socially immobile. Like other persons with chronic diseases epilepsy produces a special social attitude and often negative therapeutic motivation. In contrast to the literature non-hospitalized epileptics show normal intelligence. Neurotic symptoms are seen in many cases however (about 40%). Often social disturbances origin from broken home situations. There is no specific social and mental defect. According to the own experience social integration of epileptics depends upon the local economic structure. The common prejudice varies with the local area. Social drop-outs are not due to the seizures, but occur mainly in mentally retarded persons who are not able to follow therapeutic regimens. Delinquency is increased among the own patients (18%). The causes are psychoorganic syndromes, often in connection with negative therapeutic motivation and alcoholism. The tendency to specific crimes, known from the literature, could not be confirmed. Forensic problems in direct connection with epileptic fits are rare. Medical problems concerning ability to drive often occur. Many patients possess a driver licence (46.5%), gained after onset of epilepsy in 50%. But the accident rate is lower than in the general population. Special outpatient departments and therapeutic groups for epileptics--affiliated to neurological centers--can improve the exact diagnosis, therapeutic motivation and social integration.