New review study considers use of facemasks for people with epilepsy

A new article recently published in the medical journal Acta Neurologica Scandinavica has concluded that people with epilepsy should wear a facemask in public insofar as possible in response to the Covid-19 pandemic. 

The article entitled "Is wearing a face mask safe for people for people for epilepsy?" sought to provide advice on the practice for people with epilepsy. 

The authors state that wearing a mask is a simple, cheap and impactful preventative measure that can limit the spread of COVID-19. They state that the use of face masks
should not create a false sense of security and that other measures, such as hand hygiene practices and physical distancing are also essential measures.

The paper acknowledges that the wearing of a mask could theoretically cause hyperventilation. Hyperventilation is a condition in which you start to breathe very fast. Healthy breathing occurs with a healthy balance between breathing in oxygen and breathing out carbon dioxide. You upset this balance when you hyperventilate by exhaling more than you inhale and this process is known to cause seizures in some people with epilepsy. Stimulating hyperventilation is sometimes used to trigger seizures in people with epilepsy during EEG recording, although the mechanisms behind this are not fully understood.

As a result, the authors state that "we would probably avoid recommending this practice indiscriminately to all people with epilepsy". However, the article goes on to note that in the absence of a vaccine against the virus, "prevention is the best available strategy and it is probably not reasonable to suggest avoid wearing face masks in people with epilepsy under any circumstances". In addition, it must be remembered that in most cases, people with epilepsy "do not need to wear a face mask most of the time, as long as there is no close contact with others" and that "it is probably more advantageous to wear a face mask in crowded locations... with intermittent breaks in safe locations, away from others".

We would note that evidence on that this matter is limited and this is something that the authors acknowledge. With a virus as new as COVID-19, we are going to be learning about the implications for people with epilepsy - and the procedures around the virus - for some time. To that end, the paper provides advice from leading epilepsy experts and offers solid advice on the practice.

Epilepsy Ireland also reached out to Dr. Colin Doherty, neurologist at St. James’ Hospital, Dublin to seek his opinion on this paper. Dr. Doherty commented, “In the absence of a vaccine for COVID-19, the wearing of a mask is proven to be an effective preventative measure. I would agree with the paper’s conclusion that people with epilepsy should follow public health advice and wear a mask as directed and is so far as possible.”

You can read the paper in it's entirety here. See also our new section within our COVID-19 and epilepsy minisite on Facemasks and Epilepsy. You can find this new section here. Our advice is to wear a mask in so far as possible to prevent the further spread of COVID-19. 

Please continue to stay safe, follow the official guidelines and remember that we are still here for you for support & advice with your epilepsy through our team of Community Resource Officers.