Abstract
BACKGROUND: Epilepsy is a chronic disorder affecting all aspects of individual life. People with epilepsy (PwE) reach seizure control in about 60% of cases. However, social integration issues are frequently overlooked. Unemployment and underemployment are markedly more common in PwE compared with the general population. With this review, we aimed to depict the current state of the employment situation in Europe with a focus on factors that may influence it. METHODS: We performed a systematic review on epilepsy and employment as part of EpilepsyPOWER Erasmus+ project (2021-1-IT02-KA220-ADU-000028349). Our search string was "Epilepsy AND Employment OR Job OR Work." Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines, we screened 7272 articles and selected 55 articles from 1958 to 2023. We extrapolated data on employment rate and status, also considering people with specific epileptic syndromes. We finally evaluated factors contributing to employment and unemployment. RESULTS: Unemployment rates range from similar to twice or three times the rates of the general population, depending on the countries and years examined. When analyzing factors contributing to employment conditions, most papers highlighted the importance of seizure control and employers' attitudes. CONCLUSION: Developing specific legislation and programs to include PwE in the workplace could help their social integration. Moreover, seizure control seems to be the most relevant factor influencing the possibility of getting and maintaining a good job, demonstrating the importance of providing continuous follow-up and the best medical care to all PwE.