Epilepsy, seizures, physical exercise, and sports: A report from the ILAE Task Force on Sports and Epilepsy

Abstract

SUMMARYPeople with epilepsy (PWEs) are often advised against participating in sports and exercise, mostly because of fear, overprotection, and ignorance about the specific benefits and risks associated with such activities. Available evidence suggests that physical exercise and active participation in sports may favorably affect seizure control, in addition to producing broader health and psychosocial benefits. This consensus paper prepared by the International League Against Epilepsy (ILAE) Task Force on Sports and Epilepsy offers general guidance concerning participation of PWEs in sport activities, and provides suggestions on the issuance of medical fitness certificates related to involvement in different sports. Sports are divided into three categories based on potential risk of injury or death should a seizure occur: group 1, sports with no significant additional risk; group 2, sports with moderate risk to PWEs, but no risk to bystanders; and group 3, sports with major risk. Factors to be considered when advising whether a PWE can participate in specific activities include the type of sport, the probability of a seizure occurring, the type and severity of the seizures, seizure precipitating factors, the usual timing of seizure occurrence, and the person's attitude in accepting some level of risk. The Task Force on Sports and Epilepsy considers this document as a work in progress to be updated as additional data become available.

The psychosocial impact of exercising with epilepsy: A narrative analysis

“…Andrew and Rose exhibited this more over time than Gwen and Maya. These results and current research encourages people with epilepsy to learn to listen to their body and exercise safely, thus allowing a more consistent exercise regime [2,3,7,34], and subsequently lead to a reduction in negative emotional responses. Furthermore, as decreasing exercise intensity and frequency did cause a negative emotional response, research should explore ways for people with epilepsy to cope with these adaptations.…”

“…Medical advice in maintaining exercise habits differed amongst the participants and created a barrier to exercise. Although recommendations to continue exercise for emotional benefit are prevalent in current epilepsy and exercise literature [2,3,7,8,34,36,37], and were shown through recommendations to Rose and Gwen, it was interesting to witness the emotional effect of the differences in medical advice provided, as was shown through Andrew's narrative. This first-hand insight into advice provided by medical professionals as well as the support that is needed by people with epilepsy to maintain an exercise routine has yet to be presented within the literature.…”

“…Examining the difference between positive recommendations shown in research outputs and actual medical advice given should be further explored in order to increase physical activity levels for people with epilepsy. As current recommendations are to encourage physical activity [2], it is hoped that with more first-hand experiences being presented within research, medical professionals will be inspired to actively encourage exercise for people with epilepsy and therefore allow more people with epilepsy to feel confident that they can exercise safely.…”

“…Recently, the International League Against Epilepsy (ILAE)'s task force on sports and exercise promoted these benefits and provided clinical advice on how to exercise safely in regards to level of seizure control [2]. However, despite the physical and mental benefits of physical activity, exercise is still not a regular occurrence for people with epilepsy [3].…”

Epilepsia, actividad física y deporte

“…Para recomendar o decidir si se hace determinada actividad, se debe considerar el nivel de riesgo y sopesar además las siguientes variables: tipo de deporte, probabilidad de aparición de crisis epilépticas, tipo y gravedad de las crisis, factores precipitantes de las convulsiones, horario de presentación de las crisis, medidas de protección y la actitud del paciente en cuanto a asumir un determinado riesgo. El artículo llama a la sensatez, moderación y consenso en cada caso particular, en vez de proscribir o autorizar de manera general los diferentes deportes en las personas con epilepsia (56). Los deportistas de alto rendimiento con epilepsia deben informar a sus entrenadores y a las diversas comisiones deportivas sobre su tratamiento farmacológico habitual, ya que algunos medicamentos antiepilépticos o su presentación pueden ser considerados como sustancias ilícitas en las competencias deportivas (57).…”