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Sleeping with a Brain that Dissociates

to know the result while his wife is anxious for a prognosis. This dilemma may be surmounted by preliminary discussion of possible outcomes. Epilepsy often involves the family. The diagnosis carries a stigma and efforts may be made to conceal it. As the warning of an attack is brief the situation may be revealed at any time. Epilepsy also leads to constraints over employment and driving a car. The majority of subjects are well apart from the attacks. The impact on the patient is often one of continued insecurity. A recent trend towards a more open approach has increased general awareness of the disease but community attitudes are slow to change. Confidentiality on the part of the doctor is a professional requirement. It can be overruled in cases of notifiable infectious disease or in a Court of Law. Patients and families are not constrained in this way but may decide to preserve secrecy concerning illness. Again, the situation is changing and serious conditions such as cancer and dementia are now discussed more openly.