FaceMasks and Epilepsy

In this section of our COVID-19 minisite, we discuss the wearing of facemasks and offer advice regarding their use for people with epilepsy. We would remind you however that COVID-19 is a very new virus and the implications and procedures around this virus for people with epilepsy are something we are still learning about every day. We will do our utmost to ensure that the most up to date advice and information is highlighed as it becomes available. If you have any further questions that are not listed below, please do not hesitate to contact our National Information Officer, Geraldine Dunne on gdunne@epilepsy.ie or our Communications Officer, Paddy McGeoghegan on pmcgeoghegan@epilepsy.ie and we will do our utmost to seek further details on your query.


How do I wear a facemask correctly?

While we are seeing the importance of wearing a facemask being highlighted in the last number of weeks, it is equally important to ensure that you are wearing that mask correctly. See video below on how to correctly wear a facemask.

 

 

 

 

 

 

 

 

 

 

 

Why are there concerns about the wearing of masks?

For some people with epilepsy, hyperventilation can lead to increased seizures. However, this is likely to be an issue for only a small minority of people with epilepsy. This issue is addressed in a recent review article which concludes that on balance it is not reasonable to recommend against mask wearing for people with epilepsy, especially considering that in most cases, they only need to be worn in crowded areas and for a limited period of time.

In addition, there is concern from people who may be anxious about wearing a mask. Stress and anxiety can lead to seizures. While the wearing of a mask itself may not lead to a seizure, stress and anxiety around the wearing of one could theoretically do so. 

In the absence of a vaccine however and with the wearing of a mask proven to be an effective preventative measure in the fight against COVID-19, we would encourage every person with epilepsy to do their utmost to comply with the regulations in so far as possible.  If you have particular concerns, please contact us or get in touch with your GP.

My seizures are well-controlled but I have heard that there are exemptions for those who have long-term health conditions. Do I have to wear a mask?

The current criteria set out by the Government acknowledges that there may be people who may not be able to wear a mask which we have listed below:
  • trouble breathing
  • unconscious or incapacitated
  • unable to remove it without help
  • special needs and who may feel upset or very uncomfortable wearing the face covering
  • young children aged under 13
However, there are no specific conditions (e.g. epilepsy) listed as exempt under the currrent criteria for wearing a mask. We recommend that people with epilepsy should follow the guidance on mask wearing insofar as possible. Remember that visors are an alternative to facemasks should you feel excessively uncomfortable or anxious with wearing a cloth mask. We have provided further information on not wearing a mask in a later question.

My seizures aren't well controlled. Should I still wear a mask?

In the absence of a vaccine for COVID-19, a mask is proven to be one of the best preventative measures for reducing COVID-19 spread so you should do your utmost to comply with Government advice. If your seizures are uncontrolled and if you are excessively uncomfortable or anxious with wearing a mask, we have listed some tips below which you may find of benefit:

  • Try not to wear the mask for long periods of time if you can, but take short breaks in a safe location where you are not in close contact with others. 
  • If possible, go out with a member of your household or close circle who would be able to assist you if you have a seizure. Your friend or family member would be able to remove your mask during the seizure.
  • If you do have a seizure and are on your own while wearing a mask; even in these strange times; we are confident that a member of the Irish public would stay with someone who is having a seizure, keeping a safe distance while they call for an ambulance or apply seizure first aid (see more here).
  • A clear face visor is also an acceptable form of face covering per HSE guidance.

What should a person do if I have a seizure while I am wearing my mask?

Where possible, it is helpful to remove a person’s mask if they are having a seizure or if they are in the recovery stage. This will facilitate their breathing. It is important for the person assisting to safeguard themselves from potential exposure to COVID-19 through precautionary measures such as hand sanitisation (if possible) before assisting. More on seizure first aid here.

I don't feel comfortable wearing a mask and don't feel that I can wear one in public. Can Epilepsy Ireland provide me with an exemption card?

Under the guidelines issued by the Government, you are not obliged to produce evidence as to why you cannot wear a facemask and a self-declaration of your reasoning should suffice. In addition, should evidence be demanded e.g. by a private business, then it is likely that a GP letter rather than a standard 'card' printed from the internet would be required. We reached out to the HSE to seek further clarity on this. Below is their response:

A person's GP can be contacted in relation to a letter if a person has a medical reason to not wear a mask, it is at the discretion of the GP to provide such a letter. However, persons that cannot wear a face mask for any medical reason, it is sufficiant to communicate that verbally to any person that asks. 
It is stated on the HSE site that: You do not have to wear a face covering when using public transport, if you have an illness or impairment that would make wearing or removing a face covering upsetting or uncomfortable.
In relation to any transport service whether it is state provided or a private transport service, their customer services dept. should be contacted in relation to what steps can be taken if the person is refused access to their service; the HSE cannot advise on this.
Shops & all other retail units can set their own policy in relation to the wearing of face masks on their premises, they run their own business & set their own policies.

In addition to the above, we would again note the availability of visors which could be used an alternative to a mask if you were very uncomfortrable with wearing one.

Note: on the 10th August, face masks became madatory in all shops, supermarkets , shopping centres and other public buildings. The full list is available here, along with further information on facemasks.

Should my child with epilepsy wear a facemask?

Regulations around the wearing of facemasks do not apply to children under 13.

Is there any evidence emerging about facemasks and epilepsy?

A recent review article was published in the medical journal Acta Neurologica Scandinavica by epilepsy experts Dr Ali Asadi-Pooya and Prof Helen Cross. You can read more on this paper here. 

Again, we would remind readers that knowledge and understanding of COVID-19 is rapidly evolving as a whole and indeed, it's implications for people with epilepsy. Our current advice based on what is known today is to do your utmost to wear a mask in line with Government advice alongside other preventative measures against COVID-19 in the interest of your friends, families and loved ones to help prevent the spread of the virus.

#StaySafe #HoldFirm #WearAMask

More on COVID-19 and epilepsy here.