The Personal Capacity Assessment and Remaining Conscious.

The full title for this category is "Remaining conscious without having eplileptic or similar seizures during waking moments". Remaining conscious has six descriptors. The figures in brackets represent the points scored for each descriptor.

• Has an involuntary episode of lost or altered consciousness at least once a day; (15)
• Has an involuntary episode of lost or altered consciousness at least once a week; (15)
• Has an involuntary episode of lost or altered consciousness at least once a month; (15)
• Has had an involuntary episode of lost or altered consciousness at least twice in the last six months; (12)
• Has had an involuntary episode of lost or altered consciousneess at least once in the last six months; (8)
• Has had an involuntary episode of lost or altered consciousness once in the last three years; (0)

This only relates to fits when the claimant is normally awake, the handbook instructs doctors not to take into consideration any fits that occur when the claimant is asleep.

Those conditions involving loss of consciousness are listed as-

• Grand mal (classical epilepsy);
• A seizure which is secondary to impairment of cerebral circulation (eg asa result of cardiac disrythmias) or hypoglycaemia;
• Other seizures of an eleptiform nature;

States of altered concsiousness implies those states where the claimant is not fully unconscious but where there is a definitie "clouding" of the mental faculties resulting in the loss of control of thoughts and actions. Those conditions most likely to involve states of altered consciousness are listed as-

• Temporal lobe epilepsy;
• Absence seizures (petit mal).

The point is made that for this category it is less important to establish an exact diagnosis than to establish whether or not any disability is present.

Doctors are advised to take into account any side effects of medication taken to control seizures. The handbook indicates that a mental health assessment should be undertaken if those side effects are sufficient to interfere with cognitive ability or to produce any other form of mental disablement.

Giddiness, dizziness and vertigo should not be considered within this category as they do not produce either a loss or an altered state of consciousness.

Migraines are not included in this category, even if attacks are preceded by an aura.

Doctors are asked to consider the following activies of daily living-

• Whether the claimant drives- the DVLA refuses to issue a licence to anyone who has had a daytime fit in the previous twelve months;
• Potentially hazardous domestic activities such as cooking;
• Recreational activities eg swimming, contact sports.

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