- 1 Other Names
- 2 Background
- 3 Pathophysiology
- 4 Risk Factors
- 5 Differential Diagnosis
- 6 Clinical Features
- 7 Evaluation
- 8 Classification
- 9 Management
- 10 Rehab and Return to Play
- 11 Complications
- 12 See Also
- 13 References
- Seizure Disorder
- This page describes both known seizure disorders in athletes as well as new onset seizures
- Definition of epilepsy: two or more unprovoked seizures more than 24 h apart in a child older than 1 month
- Seizure disorder in the general population
- Incidence: approximately 50 per 100,000 persons per year
- Prevalence: 5 to 10 per 1,000 persons in most areas
- In pediatrics, 0.5-1% of children are affected
- Prognosis is favorable, more than 70% will achieve good seizure control and eventually remission
- People with seizure disorders have long been restricted from certain sports and physical activities
- Subsequently less fit and active then unaffected peers
- Bjorholt et al found that people with seizure disorder are only half as active as their age matched peers
- They also found declines in aerobic capacity are accelerated in individuals with seizure disorder
- Individuals with seizure disorder are more likely to abstain from physical exercise
- Wong et al compared individuals with seizure disorder to their siblings
- Teens with epilepsy were less active, had higher BMI, participated in fewer group sports
- Most commonly cited reasons for not participating: lack of time, health problems, and fear of seizures
- In some cases, advised to avoid activities by family, physician(s)
- Seizure disorder also has psychosocial implications
- Physical activity has proven health benefits in individuals with seizure disorder
- Canadian Community Health Survey
- 12-month injury prevalence was not different among those people with epilepsy and the general population
- Lower overall frequency of sport-related injury among persons with epilepsy
- Three times higher rate of hospitalization following injury in this group which the suspected was due to a more cautious attitude among health care providers with seizure patients
- Kirsch et al: cognitively normal children with epilepsy did not have a significantly increased rate of accidental injury in comparison with their nonepileptic friends
- Sahoo et al: contact sports with repetitive minor head injury fail to show any increase in seizures or to exacerbate seizure disorders
- McCory et al: Concussions with subsequent seizure activity did not lead to the development of epilepsy among 22 athletes
- Sport sports participation has been show to decrease seizure frequency rather than increase it, despite the stressors associated with physical activity and competition
- Nikken et al showed that a 4 week intensive exercise regimen lead to a slight but statistically insignificant decrease in seizure activity among individuals with uncontrolled seizure activity
- Participants also demonstrated improved aerobic capacity and fitness
- Ramirez et al found a slightly higher injury rate among students with a history of seizure (4.5 per 1000 athlete exposures) when compared to students with no seizure history (1.6 per 1000 athlete exposures).
- None of the injuries were seizure related
- Ramirez used a stricter definition counting any incident resulting in removal from play where as other studies typically define injury as restricted from sports participation for more than 1 day
Recommendations for Participation
- Based upon AMA, AAP recommendations
- No restrictions:
- Ice Hockey
- Field hockey
- Other team sports
- No restriction with supervision
- All water sports (except scuba diving)
- Absolute full restriction
- Scuba Diving
- Base jumping
- Other airborne or freefall activities
- Rock climbing
Rehab and Return to Play
Return to Play
- Shinnar S, Pellock JM. Update on the epidemiology and prognosis of pediatric epilepsy. J. Child Neurol. 2002; 17 (Suppl. 1): S4–17.
- Sander JW. The epidemiology of epilepsy revisited. Curr. Opin. Neurol. 2003; 16: 165–70.
- Fejerman N. Epilepsy in children and adolescents. Epilepsia. 2002; 43 (Suppl. 6): 44–6.
- Bjørholt PG, Nakken KO, Røhme K, et al.. Leisure time habits and physical fitness in adults with epilepsy. Epilepsia. 1990; 31: 83–7.
- Nakken KO. Physical exercise in outpatients with epilepsy. Epilepsia. 1999; 40: 643–51.
- Wong J, Wirrell E. Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy. Epilepsia. 2006; 47: 631–9.
- Arida RM, Scorza FA, de Albuquerque M, et al.. Evaluation of physical exercise habits in Brazilian patients with epilepsy. Epilepsy Behav. 2003; 4: 507–10.
- Serdari A, Tsalkidis A, Tripsianis G, et al.. Epilepsy impact on aspects of school life of children from different cultural populations in Thrace, Greece. Epilepsy Behav. 2009; 15: 344–50.
- McNelis AM, Dunn DW, Johnson CS, et al.. Academic performance in children with new-onset seizures and asthma: a prospective study. Epilepsy Behav. 2007; 10: 311–8.
- McEwan MJ, Espie CA, Metcalfe J, et al.. Quality of life and psychosocial development in adolescents with epilepsy: a qualitative investigation using focus group methods. Seizure. 2004; 13: 15–31.M
- Arida RM, Cavalheiro EA, da Silva AC, et al.. Physical activity and epilepsy: proven and predicted benefits. Sports Med. 2008; 38: 607–15.
- Arida RM, Scorza FA, Terra VC, et al.. Physical exercise in epilepsy: what kind of stressor is it? Epilepsy Behav. 2009; 16: 381–7.
- Tellez-Zenteno JF, Hunter G, Wiebe S. Injuries in people with self-reported epilepsy: a population-based study. Epilepsia. 2008; 49: 954–61.
- Kirsch R, Wirrell E. Do cognitively normal children with epilepsy have a higher rate of injury than their nonepileptic peers? J. Child Neurol. 2001; 16: 100–4.
- Sahoo SK, Fountain NB. Epilepsy in football players and other land-based contact or collision sport athletes: when can they participate, and is there an increased risk? Curr. Sports Med. Rep. 2004; 3: 284–8.
- McCrory PR, Bladin PF, Berkovic SF. Retrospective study of concussive convulsions in elite Australian rules and rugby league footballers: phenomenology, aetiology, and outcome. BMJ. 1997; 314: 171–4.
- Nakken KO, Bjørholt PG, Johannessen SI, et al.. Effect of physical training on aerobic capacity, seizure occurrence, and serum level of antiepileptic drugs in adults with epilepsy. Epilepsia. 1990; 31: 88–94.
- Ramirez M, Yang J, Bourque L, et al.. Sports injuries to high school athletes with disabilities. Pediatrics. 2009; 123: 690–6.
- Corbitt RW, Cooper DL, Erickson DJ, et al.. Epileptics and contact sports [editorial]. JAMA. 1974; 229: 820–1.
- Sports and the child with epilepsy. Pediatrics. 1983; 72: 884–5.