Epilepsy

[ Home ] [ Up ] [ Search ]

Epilepsy is a rather common disorder in society today. It is estimated that 3 million Americans are affected by epilepsy. That being said, it is extremely important for all coaches, Athletic Trainers, and other school personnel to know about the cause, treatment, and contraindications of the epileptic athlete.

Epilepsy is characterized as a seizure disorder. A seizure is the result of a discharge of electricity within the brain. They way the electricity is discharged determines how the seizure will appear.

• Epilepsy is NOT contagious. 

• Individuals with epilepsy DO lead normal lives and have normal intelligence. 

• Epileptics ARE allowed to participate in athletics. However, there may be some specific limitations placed on specific individuals due to their type of epilepsy. 

• Seizures DO NOT cause brain damage.

Seizures are scary; for both the individual who suffers one and for anyone watching the event. A seizure can present it self in one of several ways. Generalized seizures are characterized by a massive release of electricity within the brain. This type of seizure is usually characterized by loss of consciousness, falling, and whole body convulsions or muscle spasms. This is referred to as a tonic-clonic or grand mal seizure. This type of seizure is the classic epileptic seizure.

The second general type of seizure is a referred to as a partial seizure. In the brain only a specific area is affected by the electrical discharge. Consequently, the area of the body controlled by that portion of the brain is affected. This may be manifested in muscle spasms affecting only the left side of the body.

A third type of seizure begins with a partial seizure that generalizes. That is, it starts in a specific area of the brain but then quickly spreads to the entire brain. This is referred to as partial seizure secondarily generalized. Individuals with this type of seizure disorder may have an aura. The partial seizure manifests itself with a strange smell, flashing lights, or “seeing stars.” This aura serves as a warning to the epileptic that a generalized seizure is about to begin. Unfortunately this warning may only be a few seconds before the generalized seizure begins.

Partial seizures are the most common form of seizure in adults, affecting six out of every ten people with epilepsy. Among children with epilepsy, four out of ten have partial seizures.

Partial seizures may be called simple partial seizures or complex partial seizures. The main difference between them is whether people remain fully aware or experience a change in consciousness during the episode.

A seizure usually begins with the individual staring blankly into space, referred to as absence. This may be followed by chewing, picking at one’s clothing, apparently involuntary arm or leg movement, or mumbling. The individual may appear generally coherent but then begin to do incoherent actions. This may include walking around, undressing, running, screaming, or display mental agitation.

If the seizure becomes generalized, the person will lose consciousness and fall to the floor. This is when the convulsions or involuntary muscle spasms begin. The arms, legs and torso will jerk in an uncoordinated manner. Many times the person suffering the seizure will loose bladder or bowel control. This can be a source of embarrassment for the epileptic.

During the seizure, breathing may cease or become erratic. Do not be alarmed if the individual shows signs of hypoxia. When the seizure stops, breathing should return to normal.

If an athlete, or someone else, is having a seizure immediate first aid is very simple. First, protect their head, especially if the individual is on a hard surface, by placing a pillow or folded jacket under the head. Secondly, remove any object that the affected individual may inadvertently strike with their arms or legs. After the seizure, stay with the individual and monitor their vital signs as in any emergency situation.

• Activating EMS should be done under the following conditions: 

• If the person suffering a seizure has no medical alert tag pertaining to epilepsy, 

• The seizure lasts for more than five minutes, 

• If the person is pregnant, 

• If the person is injured,

• A second seizure begins after the first, or 

• If the individual does not regain consciousness. 

Seizures are not considered medical emergencies under “normal” circumstances. But, remember if in doubt, activate EMS. When working with school age children, your school’s policy may be to transport to a hospital regardless of the circumstances.

DO NOT restrain the individual having the seizure. Holding them down may result in muscle or joint damage due to the restriction of motion.

DO NOT place any object in their mouth. This may result in the first aider being bitten or damaging the teeth of the person having the seizure.

After the seizure turn the individual on their side to prevent aspiration of any vomit. Vomiting during a seizure is a common occurrence.

Another important bit of information is the duration of the seizure. Normally, a seizure will last for one to two minutes. Many times the treating physician will want to know the duration of the seizure as a way to tracking progression or changes in the condition.

Epilepsy is generally controlled with appropriate medication. The four main medications are: Dilantin®, Depakote®, Phenobarbital, and Tegretol®. Many other medications can be used to treat epilepsy, new drug therapy is emerging every day. The treating neurologist will prescribe one or a combination of these and other drugs to control the epilepsy. Blood levels of the drugs are routinely taken to ensure a therapeutic level.

Seizures can be triggered by alcohol consumption, lack of sleep, flashing lights, high levels of stress or high fever. Each person is different and should learn to manage these things to help control their epilepsy. Managing these risk factors is essential in controlling epilepsy.

Athletes with epilepsy are at no greater risk for injury or pose no risk to their team mates while participating in sports. A few cautions need to be observed with the epileptic athlete, however.

The causative factor for the epilepsy will determine sport participation. For example if the epilepsy is due to a head injury, the athlete will be disqualified from collision and contact sports (football, hockey, lacrosse, etc.). Care should be taken with swimming, diving, and rock climbing as these sports can pose other problems if a seizure occurs during participation.

Physical activity and sport participation has been shown to aid in seizure control. The decision to participate in sports should be made with input from the treating physician, athlete and parents of a minor child. The epileptic athlete can be an able contributor to any interscholastic athletic team.

©2000 - 2009 David Edell

Information on this site is not a substitute for physician directed care.

Please consult your personal physician for more detailed information

concerning specific injuries or illnesses.

Last Update for AthleticAdvisor.com: 10/24/2009 12:09:35 AM