Approximately one in 26 Americans will develop epilepsy at some point in their lives, and as a result, may not be able to drive. Public transportation can be an important resource for people with epilepsy — to help them stay active and connected with their community. Because a passenger may experience a seizure while using public transportation, it is important to know the warning signs of seizures and be prepared to respond appropriately. This is particularly important for public transportation vehicle operators.

Easter Seals Project ACTION and the Epilepsy Foundation recently produced a pocket guide, titled “Seizure Disorder Awareness for Transportation Operators & Customers,” to offer tips and information about riding transit and seizure safety for transportation operators and customers.

Signs of Seizures
Epilepsy, also called a seizure disorder, is a neurological, medical condition. Seizures can be thought of as electrical overloads in the brain and can take many forms. Some are brief and hardly noticeable, whereas others present as convulsions that can be upsetting to those who see people having them. Some common behaviors that occur during a seizure include:

• Staring ahead without response to verbal commands or conversation.

• Losing awareness, losing consciousness or becoming confused.

• Experiencing stiffness of limbs and/or shaking of limbs — this is also called a convulsion.

• Experiencing a change in emotional state.

• Picking at and/or fiddling with items in a purposeless way.

• Using inappropriate language or agitated aggressive behavior.

• Falling.

Key Facts to Know
Important epilepsy facts for transit operators to know include dispelling the myth that a person can swallow his tongue during a seizure. The Epilepsy Foundation recommends never putting objects, like pens or a wallet, in someone’s mouth while they are having a seizure. The items may cause injury to the person’s teeth and gums. It is best to turn the person on his side to decrease the chance of his breathing in saliva. However, do not risk injury to the person if it is difficult to turn him on his side. Do allow the person to rest on his side after the seizure until he is ready to get up.

How to Respond
Some people can become agitated and combative during and after seizures. They are not aware of what they are doing. Agitation can happen when a person becomes confused during or after a seizure. Do not forcibly restrain the person having the seizure. Remain calm and remove objects in the immediate area that might injure the person, like strollers and packages. Try to guide the person to a safe position. Once the seizure is over and the person is fully awake, help them into a resting position.

People who experience seizures on public transportation cannot be asked to leave the vehicle or be denied a ride. If you are an operator, refer to U.S. Department of Transportation Americans with Disabilities Act regulations and your agency’s service policies for more information. There is no reason a person who has fully recovered from a seizure cannot stay on the bus until she arrives at her destination. If the person is traveling with a service animal, the service animal should remain with the individual and is protected under the ADA.

For questions related to seizure disorders, the ADA, and serving people with disabilities contact the Epilepsy Foundation at (800) 332-1000 or Easter Seals Project ACTION at (800) 659-6428.