Eighty five civil servants with epilepsy who were referred to the Civil Service Occupational Health Service over an 18 month period formed the study population. The reasons for these referrals and their outcomes have been analysed. The main reasons for referral were prolonged or frequent sickness absence, unsatisfactory work performance, epilepsy starting during employment, the discovery of undisclosed epilepsy, and for advice on working conditions. In 30 the outcome was medical retirement, although in only 15 was this due to epilepsy alone. Of the other 15, medical retirement was necessary in four because of the combination of epilepsy with another medical disorder, and in 11 because of a coincidental condition unrelated to their epilepsy. Only six out of 15 referred on account of epilepsy related sickness absence, and none of the 14 referrals due to epilepsy related unsatisfactory work performance resulted in early retirement. This reflected the invaluable role that the occupational physicians had in recognising where problems were due to poor control of the epilepsy or to the side effects of the antiepileptic medication and in arranging through general practitioners or hospital doctors for appropriate adjustment of the drug regimen. Nine of the 22 subjects who developed epilepsy during employment, however, were retired on medical grounds.
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