What is Epilepsy?
Epilepsy is a disorder in the central nervous system that affects brain activity and causes seizures; periods of unusual behaviour; and loss of awareness. This disorder can occur in people of all age groups, regardless of their gender, race or ethnic backgrounds.
A recent report showed that in 2019-20, there are estimated 142,740 people with active Epilepsy in Australia which costs a total of 12.3 Billion dollars.
(http://www.epilepsyaustralia.net/uploads/74689/ufiles/PDF/Economic_burden_of_epilepsy_-_Final_Report_-_Feb_2020.pdf)
Simplistically, Epilepsy can be Partial ( Focal) or Generalized. This is further classified as Simple ( with no loss of consciousness) and Compes ( with loss of consciousness). There are further subgroup classifications used in specialized fields of medicine
The seizure symptoms vary from person to person. Some patients simply stare blankly while experiencing a seizure; and some twitch their arms and legs repeatedly. A single seizure doesn’t point towards epilepsy. In order to diagnose this condition, the person should have experienced a minimum of two unprovoked seizures. Recurrence rate for a seizure after the first episode is about 70%
The seizures are generally self limiting. The immediate management of seizures should start with focus and maintenance of airway, breathing and circulation. The convulsing person should not be restrained, avoid putting anything into the mouth.
Most physicians understand seizures as secondary to an organic disorder in the patient’s central nervous system. The type and frequency of seizures is not the same in all the people who have epilepsy. That is why it is extremely important to assess each patient’s epileptic symptoms carefully and then provide proper physical activity recommendations.
Epilepsy in Sports
Epilepsy affects about 2% of the population. It has long been common for patients with epileptic symptoms to be restricted from participating in some sporting activities. In the past it has been believed that sports participation puts athletes at a risk for recurrence of seizures due to hyperventilation, fatigue, direct or indirect head trauma. However these risks are for most part, theoretical. Hyperventilation during activity unlike voluntary hyperventilation, in fact does not trigger seizure activity.
Benefits of Sports Participation in Epilepsy
Sports participation in fact has been seen to reduce the frequency of the subsequent seizure especially with aerobic exercises. Further participation in physical activity improves mood and quality of life. This is also true for participation in contact sports.
It has been found that with the utilization of proper protective equipment, epileptic patients can safely play team and even collision sports. Such participation does not increase the risk of injury or seizures in any way. However, it still isn’t advisable for them to participate in sports like scuba diving and skydiving. Overall, there are far more benefits than risks of participating in suitable sports and recreational activities.
Considerations for participation in specific sports
Generally, water sports are permitted with precautions. Additional support from supervised persons and equipment as floating devices is advised. Scuba diving, underwater competitive sports are best avoided especially with uncontrolled Epilepsy.
On similar lines, sports at heights such as skydiving, hang gliding, free climbing are discouraged with precautions executed for participation in Gymnastic, acrobatic sports, shooting, and Equestrian sports.
Conclusion
Taking the current evidence into account there is no requirement for patients with epilepsy to avoid most of the sporting activities. These people will gain much more physical and psychological benefits than any kind of risk. It’s getting increasingly clear that decisions of restriction from sports participation need to be individualised after risk- benefit analysis, which results in only minimal restrictions.