Nikesh Ardeshna, MD, MS
Epilepsy Fellow
Wayne State University
Detroit Medical Center
Kore Liow, MD
Director
Via Christi Comprehensive Epilepsy Center
Clinical Associate Professor of Medicine (Neurology) and Psychiatry
Kansas School of Medicine-Wichita
Sandra Helmers, MD
Associate Professor of Neurology
Emory University School of Medicine
Anup Patel, MD
Pediatric Epilepsy Specialist
Capitol Neurology Group
Riley Hospital for Children
Gregory Holmes, MD
Chief of the Neurology Section Dartmouth Medical School
Past President
American Epilepsy Society
Elizabeth A. Thiele, MD, PhD
Director
Pediatric Epilepsy Program
Massachusetts General Hospital
John Pellock, MD
Professor and Chairman
Division of Child Neurology
Virginia Commonwealth University
Blanca Vazquez-Santana, MD
Clinical Assistant Professor
New York University Medical Center
Questions About Adult Epilepsy
Antiepilepsy medications can have side effects that may indirectly influence a person’s ability to perform a sport. “Many antiepileptic medications are associated with fatigue, for example,” says Vazquez. Those on higher dosages of AEDs may experience dizziness and may want to avoid exercise at that time. “Another consideration is that some antiepilepsy medicines can cause joint pain, which may affect performance of a sport,” she says.
“Any type of cardiovascular exercise, such as walking, running or bicycling, can be beneficial, but no one type of exercise has been proven to be more beneficial than any other for people with epilepsy,” Ardeshna says. He cautions against activities that involve heights, as well as exercises that have the potential for head injury, collisions or falls since resulting injuries may lead to an increase in seizures.
“General precautions should be taken, including all the necessary protective gear specific to a sport, such as wearing a helmet, elbow, and knee pads for bicycling or roller blading,” Ardeshna says. Water sports involve another level of protection. “Always use the buddy system and swim with another person,” he cautions. In addition, Ardeshna advises wearing a life vest and avoiding swimming in open water, such as oceans, rivers or lakes. You may also want to inform lifeguards that you have epilepsy, especially if your seizures are not under control, and you should avoid diving to protect against head injury.
Questions About Childhood Epilepsy
For reasons not yet known, a ketogenic diet – one that’s very high in fat and low in carbohydrates—can help lessen seizures or eliminate them altogether in some children. The diet forces the body to burn fat rather than glucose for energy. Because this approach involves a radical change in eating habits, including high quantities of cream, mayonnaise, bacon, and other fatty foods, and only limited vegetables, the diet should only be used when medications have failed, and then only with the supervision of your physician and a dietician familiar with epilepsy, Helmers says. &147The diet needs fairly strict monitoring,” she adds. “The process usually begins with a period of fasting for one to three days, usually in the hospital.” Also, for reasons unknown, a ketogenic diet is only effective in children up to the age of puberty. Helmers says children should remain on the diet for a maximum of 2 years before being weaned off it.
“Doctors usually have a good reason for changing anticonvulsant medications,” Helmers says. “The current drug may be ineffective or may be causing side effects of its own. If the switch over is gradual and is monitored carefully, it shouldn’t be a problem.” Still, it’s important that you and your child clearly understand the doctor’s reasoning, Helmers adds.As with any medication, epilepsy drugs sometimes cause side effects, including fatigue, slurring of speech, irritability, or occasionally something more serious, according to the Epilepsy Foundation. You should discuss any side effects immediately with your physician, Helmers says. “Sometimes, the side effects can be lessened by changing the dosage.” Or your child may need to try yet another medication.
“No child should swim alone—even adult swimmers should have buddies,” Liow says. Beyond that, how much freedom your child has in the water will vary from case to case. The important thing is to play it safe without overprotecting and making your child feel different or left out. “If you have a child who is having 20 seizures a day, then, obviously, swimming is not a good idea. But if they have one seizure every six months, don’t make things miserable for them by keeping them out of the water,” Liow says.
If your child is going away to camp, it’s vital that you inform counselors or anyone else who will be supervising your child about the condition so they can be extra vigilant during activities such as swimming, Helmers says. Some children, frightened by their own seizures, may be hesitant to swim. Liow advises that parents allow them to participate at their own comfort level, perhaps with floating devices or other safety gear, until they get comfortable in the water.
Read more Doctor Q&A in our archive.