National Epilepsy Week

This week, 20 to 26 June, is National Epilepsy Week, so I thought it appropriate to give you some insight into this often misunderstood condition. I will also discuss considerations that must be taken into account when people with this condition participate in any physical activity.

Epilepsy is defined by The American College of Sports Medicine (ACSM) as: “a chronic, neurological condition characterized by temporary changes in the electrical function of the brain”. These changes in electrical function negatively affect the transmission of information between nerve cells, resulting in seizures. Awareness, movement and/or sensation can be affected during a seizure.

Most often, the cause of epilepsy is unknown; however, common causes include head injuries, tumours, infections, strokes, and lead poisoning (ACSM).

Besides seizures, the following symptoms may occur (ACSM):

• Headache
• Changes in mood or energy
• Dizziness
• Fainting
• Confusion
• Memory loss
• Babbling

Often, one experiences an aura, or warning, before a seizure occurs, which may include (ACSM):

• Dizziness
• Tingling
• Peculiar smell or taste
• A feeling of euphoria
• Auditory hallucination
• And/or painful sensations

Various forms of epilepsy exist; therefore, it is extremely important that this condition is accurately diagnosed by a neurologist, so that the appropriate treatment can be applied. Blood tests, a CT scan, EEG, MRI, and lumbar puncture can be used to diagnose epilepsy; however, a full physical examination must also be done to rule out any other conditions that may cause seizures.

Three main types of seizures exist: a grand mal lasts about 50-90 seconds and involves a loss of consciousness, collapsing, rigidity, and an increased heart rate. A person is usually very tired and sleepy after such a seizure. A petit mal generally last 3-10 seconds and presents as a blank stare or loss of focus. A person usually recovers quickly, but may have multiple episodes. A psychomotor or temporal lobe seizure usually lasts 1-5 minutes and includes a blank stare, lack of awareness, daze, mumbling, struggling, and being afraid. This state of confusion can last a while after the episode and individuals may not remember what they were doing.

According to ACSM, exercise has not been shown to cause seizures; however, it is important to be aware of certain precautions that must be taken when dealing with an epileptic. If seizures are controlled, epileptics can generally partake in any physical activity, including contact sports, although individual sports are generally preferred. High risk activities, such as mountain climbing and underwater activities, must be very carefully supervised and the supervisors must be made aware when an epileptic is participating and how to deal with that person if s/he has a seizure. Triggering factors, such as strobe lights, excessive fatigue, hypoglycaemia (low blood sugar) and alcohol intake, must also be considered.

ACSM states that regular physical activity can, in fact, reduce seizures, as there is improved mental alertness and suppressed electrical activity in the brain. Therefore, it is important that epileptics maintain an active lifestyle. Such individuals are often overprotected by their loved ones, resulting in them being less active and very unfit. This contributes to a sedentary lifestyle and the unfavourable complications that go with it.