Serious injuries to people with epilepsy rarely occur during participation in sports. Believe it or not, the bathroom is much more dangerous to a teen with epilepsy than a soccer field or ice rink.

Because epilepsy affects each person differently, however, the approach must be on a case-by-case basis. The seizure type and frequency of the seizures, the type of seizure medicine you use and its side effects, how responsible you are, and the nature and supervision of the activity must all be considered.

Common sense should be the guiding force in making these decisions. The goals should be both safety and a lifestyle that is as normal as possible. No activity is completely safe. Making safety the exclusive concern will unnecessarily limit your activities. While restriction and isolation from activities don't help you feel like just another face in the crowd, certain activities and sports can be dangerous for people with epilepsy.

The type of seizures and their frequency are critical in determining which activities are safe. If you lose consciousness or cannot control your movements during seizures, you are at higher risk for injuries. If you have uncontrolled, frequent seizures, you should know that certain activities are restricted. For example, you should not swim alone, climb to dangerous heights, or climb ropes without a proper mat and someone there to spot you. Other activities, such as riding a bicycle in traffic, also should be avoided, but you may be permitted to bicycle in safer settings.

If most of your seizures happen at certain times (within 2 hours of awakening, for example), activities can be scheduled for times when seizures are less likely to occur.

Seizures are rarely provoked by exercise, but when this pattern is identified, physical exertion should be limited. However, it may be possible to devise a satisfactory program of exercise in which the level of exertion is gradually increased. Prolonged physical activity in a hot environment may provoke seizures. In such cases, plenty of cool drinks and frequent rest periods can help reduce the risk of seizures.

Teens with epilepsy are encouraged to participate in group and competitive sports, such as league baseball, community sports, and varsity sports at school. These activities are usually well supervised and require appropriate safety gear, and most teens with epilepsy can safely participate without special accommodations. Participating in these types of activities will help you feel better about yourself, increase independence, and help you keep in shape. These benefits are extremely valuable, and the risks of participation must be serious to keep you from joining group activities. Most potential hazards can be overcome. In fact, players with epilepsy can be found in major league baseball, ice hockey, and other professional sports.

 

Swimming and water sports

Swimming is a pleasure all teens should be encouraged to enjoy. Although water poses special dangers for people with epilepsy, epilepsy is not an insurmountable barrier to swimming. The issue of epilepsy and water safety is really a question of how much supervision is necessary. No matter how severe or frequent your seizures, you can enjoy the water. A parent can hold smaller children in a shallow pool with little risk, for instance. If your seizures are well controlled, swimming should be encouraged, although it is necessary to make sure that at least one person who knows that you have epilepsy and who knows basic lifesaving is nearby. This person can be another teenager.

 

The most difficult decisions about swimming involve teens who do have occasional seizures that interfere with consciousness or control of movement. These teens should be allowed to swim, but they must be closely supervised. There should be a lifeguard on duty who is responsible and aware of the disorder, as well as another person in the pool who acts as a "buddy." Unfortunately, lifeguards are often immature adolescents who may be easily distracted. The lifeguards should know that they must keep their eyes on the pool while the person with epilepsy is swimming.

The buddy system, used by many camps for young children who swim (and by adult scuba divers), is another precaution to ensure safety. The buddy should be responsible, understand the need for keeping an eye on the person with epilepsy, and should never go far away in the pool.

It is much safer to swim in the clear water of a pool than in a lake, bay, or ocean. A person swimming in open waters can disappear in seconds and be impossible to locate quickly, especially if the water is murky or dark. Extreme caution must be taken when a person with epilepsy, especially one with poorly controlled seizures, swims in open waters. The wearing of a lifejacket is recommended in this setting.

A teen with epilepsy who wants to swim competitively should be encouraged. Competitive swimming practices and matches are usually well supervised. The coach should be aware that the teen has epilepsy, however. Everyone involved, including the teen, should make an informed decision about whether this activity is worth the additional risk.

Teens with well-controlled seizures can snorkel and may even scuba dive. People of any age with uncontrolled seizures that interfere with consciousness or control of movement should not scuba dive and should only snorkel in relatively calm water, very close to someone who has lifesaving skills.

High diving poses clear dangers for people with epilepsy. Only those with well-controlled seizures should consider high diving.

 

Bicycling

Bicycles are a part of childhood and are often an important mode of transportation for people of all ages. Yet a bicycle, if ridden on or near the street, presents a serious potential danger for a person with uncontrolled epilepsy. During a complex partial seizure, for instance, the person may suddenly veer off into the street, out of the reach and protection of anyone else riding along behind.

 

People with epilepsy can learn to ride and enjoy bicycles, however. Because most serious bicycle injuries involve the head, everyone who rides a bicycle should wear a helmet. If the seizures are under control or do not interfere with movement or consciousness, bicycle riding can be unrestricted. When the seizures pose a danger, bicycles can be ridden in a park or other place where there are no motor vehicles.

Stationary bicycles for exercise pose no serious danger for poeple with epilepsy. Ideally, the floor should be carpeted or padded. Low-seated bicycles are the safest.

 

Horseback riding

Horseback riding can be safe and fun for people whose seizures are well controlled or always preceded by an adequate warning. Those who have seizures that could cause them to fall off the horse can ride but must be closely supervised. Someone may need to walk alongside the horse. The risks and benefits of horseback riding must be carefully weighed for these people.

 

Competitive horseback riding often involves galloping and jumping and should only be considered for people with mild or well-controlled epilepsy.

 

Contact Sports

Contact sports such as football, basketball, soccer, rugby, and ice hockey are generally safe for teens with epilepsy. The principal concern with contact sports is the chance of injury to the head or body, but people with epilepsy are not necessarily more likely to be hurt than other people. If an absence or complex partial seizure occurred during a game, there is a small chance of injury if someone were to tackle the person, for instance, during the spell. Tackle football, rugby, and ice hockey have a higher incidence of injuries than most other sports and participation in them should probably be limited to those with well-controlled seizures. There is nothing wrong, however, with a person who has occasional or even frequent seizures playing touch football in the back yard. The risks must be weighed against the benefits of the sport. The chances of serious injury are small compared with the positive effects of team participation.

 

It would be hard to recommend boxing for any teen, and even less for a teen with epilepsy. The goal of boxing is to inflict a head injury. Since a momentary lapse can mean taking a hard hit directly to the head, people with absence seizures or complex partial seizures are at particular risk of injury from boxing. Head injuries also can aggravate a seizure disorder. Teens with epilepsy should avoid boxing, as well as fights with other people.

Wrestling may be safe for people with well-controlled seizures or seizures that do not interfere with consciousness or movement. It can be dangerous for other people with epilepsy.

Some forms of gymnastics are dangerous for people with epilepsy. Only those with well-controlled seizures should consider performing on the high bar, uneven parallel bars, vaults, or rings. Other gymnastic events, such as floor routines and the pommel horse, pose little risk. The parallel bars are of intermediate risk; the risk reflects the specific exercises being done. Climbing a rope higher than 5 feet is also dangerous if seizures are not well controlled.

Topic Editor:Gregory L. Holmes, M.D.
Last Reviewed: 10/23/06