Epilepsy and Military Service: Seizure Frequency Decides

The short answer: it comes down to the number of seizures per year. Article 21 of the Schedule of Diseases sets three steps with precise thresholds: five or more seizures a year gives category D; fewer than five, or one seizure in the past five years, gives category V; and a seizure more than five years ago, or changes on EEG alone, gives category B-4 — fit to serve.

Which fitness category epilepsy yields

What the regulation counts as epilepsy

The definitions are given directly:

Epilepsy is a condition characterised by repeated (2 and/or more) epileptic seizures not provoked by any immediately identifiable causes.

An epileptic seizure is the clinical manifestation of an abnormal or excessive discharge of brain neurons.

An important consequence follows: a single seizure is formally not yet epilepsy, yet it is still covered by the article — clause «b» if it occurred within the past five years, clause «v» if earlier.

Which seizures the article excludes

The list of exclusions is short but significant:

This article does not cover seizures associated with alcohol withdrawal, those developing immediately after or in the early period (up to 10 weeks) of head injury, in the acute period of stroke, meningitis or encephalitis (up to 4 weeks), or during acute hypoxia…

The logic is simple: these are provoked seizures with an immediately identifiable cause. They are assessed under the article covering the condition that caused them.

Epileptiform EEG activity without seizures

A separate and often unexpected line: changes on the electroencephalogram without clinical manifestations fall under clause «v» — category B-4. An EEG finding alone therefore does not exempt, but neither does it pass unnoticed: it restricts assignment.

It works the other way too: a normal EEG does not cancel documented seizures. Interictal recordings frequently show nothing, and the regulation accounts for this by relying on the fact of a seizure rather than the tracing alone.

How a seizure is confirmed

Here article 21 contains a provision found almost nowhere else:

The occurrence of a seizure must be confirmed by medical observation; other medical documents confirming an epileptic seizure may also be taken into account.

To confirm the occurrence of an epileptic seizure, written statements by witnesses may be taken into account where the description gives grounds to consider the seizure epileptic. The authenticity of the witnesses' signatures must be notarised or certified by the signature of the unit commander and the unit's seal.

So a seizure that happened at home or in the street and never reached a doctor may still be counted — but only through a written witness statement with a notarised signature. This is a rare case where the regulation explicitly describes a route for "no doctor was present".

What your records must contain

• Records of each seizure with date and description — the basis for counting frequency.
• Discharge summaries from any admissions.
• EEG, including with sleep deprivation: epileptiform activity carries weight in its own right.
• Brain MRI — to look for a structural cause; how such reports read is covered in reading an MRI report.
• A neurologist's or epileptologist's conclusion with the form and course.
• Notarised witness statements where seizures were not observed by a doctor.
• The chart code is G40.

What is usually missing

• Seizures occurred but none was documented — frequency cannot be counted.
• There is a normal EEG and the diagnosis is questioned on that basis, although interictal recordings are often normal.
• Provoked and unprovoked seizures are not distinguished; the regulation excludes the former.
• Witness statements exist but without notarised signatures.
• The date of a single seizure is not stated, yet the choice between clauses «b» and «v» depends on it.
• A seizure is confused with fainting: different conditions, with a general overview in the piece on dizziness.

Questions for your doctor

• How many seizures of mine are documented over the past year?
• When were the first and the last seizure — with dates?
• Is there epileptiform activity on my EEG?
• Are my seizures considered provoked or unprovoked?
• What did the brain MRI show?

Neurology at departmental boards

The above concerns assessment under Government Decree No. 565. The Interior Ministry, National Guard, Federal Security Service and Emergencies Ministry use their own schedules of diseases, with stricter requirements. A review under article 21 shows how complete your records are but is not their regulation.

The short version

Epilepsy is the article with the clearest thresholds in the whole Schedule: five seizures a year, five years since the last one, and the presence or absence of symptoms alongside EEG changes. What decides is a documented seizure history — and that is what is most often missing. Where a doctor never witnessed the seizures, the regulation expressly allows witness statements with notarised signatures, an option almost nobody uses. Only the military medical board determines the fitness category.