People around the world are engaging in various forms of physical exercise.  They are active, keeping fit & participating in the sports they love...

But, what if you or one of your friends are one of the 50 million people world-wide that have been diagnosed with epilepsy – is such a lifestyle still possible?  Can you still participate in physical exercise and sports, are there certain precautions that should be taken or certain activities/sports that should be avoided and what are you to do if someone has a seizure on the sporting field? 

Let's look at the facts of epilepsy and exercise and answer some of these questions:

What is a seizure & when is it epilepsy?

A seizure occurs when a person experiences a sudden episode of dysregulation of the normal electrical activity in their brain and this can manifest in various ways, such as in “staring spells", strange, repetitive or jerking movements, stiffening or relaxing of the muscles etc. and may or may not be accompanied by the loss of consciousness.  Episodes can last anything from seconds to a couple of minutes and are usually self-limiting.   Preceding “auras" in the form of “a funny feeling" or sensory awareness and post-event tiredness, sleepiness and/or confusion is common. 

Seizures can be caused by various conditions (infection, fever, toxins, strokes, trauma, electrolyte abnormalities etc.), mimicked by others (e.g. migraine, other causes of losing consciousness etc.) A single episode (experienced by 8-10% of all people during their lifetime) is not necessarily the same as epilepsy.  The diagnosis is only considered once the seizures become recurrent, and other possible causes have been excluded.  A registered medical doctor will follow a process of thorough evaluation, special investigations and follow-up before diagnosing and classifying the condition according to International guidelines.  Various medications (individually tailored) are available to treat the condition and about 49% of people (if they take their medication correctly) will be able to control their seizures on a single drug.  In about 17% of individuals, two or three drugs may be needed. 

Can someone with epilepsy still exercise and participate in sport?

Evidence has shown that people with Epilepsy are often less active than their peers.  Reasons for this are multiple and include prejudice, unawareness, stigma, fear of having a seizure, overprotectiveness of loved ones etc. It has however also shown that people with epilepsy (if they take the right precautions) do not experience more injuries than those without and that sports participation does not affect treatment effectiveness.

Some people even experience better seizure control when they do exercise and therefore physical activity should ideally be part of a comprehensive treatment plan.  Only about 10% of individuals (mostly with a certain type of epilepsy) experience exercise as a pure seizure-trigger, but your doctor should be able to help you identify if this might be true for you.

Those with epilepsy also benefit from all the psychological benefits of exercise and exercise has also been proven to specifically aid in the management of mood disorders and suicidal thoughts. These have been shown to be associated with the condition and certain of the medications used to treat it.

Are there any precautions that needs to be taken when someone with epilepsy engages in exercise or participates in sport?

• Medical clearance needs to be obtained before participating.
• Seizures need to be well controlled and treatment adhered to.
• Training-buddies are great, and it would wise not to exercise alone.
• a Medic-Alert bracelet identifying the condition is recommended.
• “Fragile states" that predisposes to seizures should be avoided:

Certain elements related to exercise and sport are known to cause “fragile states", that can predispose one to seizures.  Things like exhaustion, increased stress, sleep deprivation, low blood sugar, overheating and dehydration are all best avoided during training, travel and competition.  The use of alcohol and recreational drugs can also contribute to the development of such a state.  

• It is advisable that your coaches, trainers and trusted training buddies are informed of your condition and equipped with “rescue medication" and an emergency action plan.
• “Rescue medication" in the form of buccal Midazolam or Lorazepam (your doctor can issue you a script) should be at hand during training and competition.
• ​All Cannabinoids (natural and synthetic) are prohibited in-competition by the World Anti-Doping Agency and self-medication with Marijuana (even though practised by some people with epilepsy) is not advised and illegal in sport.