Epilepsy and exercise

About epilepsy and exercise

Epilepsy is a common condition of the brain in which a person has a tendency to have recurrent unprovoked seizures. People with epilepsy and their families are often concerned about exercise triggering seizures, which can result in overprotection and needless activity restrictions.

Exercise and epilepsy

Exercise is good for everyone, but it also has important benefits for people with epilepsy. Occasionally seizures can be triggered by physical exercise, but this is rare. In general, physical exercise doesn’t worsen epilepsy or cause seizures. It can offer positive physiological and psychological changes which may improve seizure control through improved overall health and wellbeing.

People with epilepsy can safely participate in most sports, as long as they avoid anything that may increase their individual seizure risk such as overexertion, over-heating, dehydration, and low blood sugar (hypoglycemia).

Special care or caution is needed with sports involving heights, such as some types of gymnastics (parallel bars and uneven bars) or horse riding. Someone with epilepsy should never swim alone.

Sports that involve extreme risk if a seizure should happen, such as hang-gliding, scuba-diving, downhill skiing, free climbing and car or motorbike racing are not recommended.

Additional limitations are necessary for people who have frequent seizures, or whose epilepsy is accompanied by other disabilities.

Sports and exercise is generally a good lifestyle choice. It can enhance your quality of life, reduce other or future health issues, and potentially have a positive effect on your seizure frequency.

Exercise safety issues and epilepsy

General safety considerations may include:

• Avoid your known seizure triggers – for instance, if lack of sleep can be a seizure trigger for you, get a good night’s sleep before playing sport, or avoid exercise if you are overtired.
• Stay well-hydrated and eat something before exercising.
• Don’t continue exercising if you feel faint, lightheaded, nauseous or generally unwell.
• Don’t overexert yourself – know your limits.
• If heat or becoming overheated is a trigger for you, exercise in an air-conditioned gym or at a cooler time of day.
• Make sure your coach and teammates know what to do if you have a seizure.
• If involved in individual exercise, consider wearing a medical alert bracelet or pendant, so people can easily identify you have epilepsy if a seizure happens.
• Wear protective gear appropriate to your sport, such as a helmet.
• Always wear a life jacket when involved in water sports.
• Let family or friends know your walking, jogging or exercise route before you leave, and how long you will be out.
• Consider carrying a mobile phone with an ICE (in case of emergency) telephone number listed.
• Always take your medication as prescribed.

Antiseizure medications and exercise

Antiseizure medications are the mainstay of epilepsy treatment but some of the side effects are likely to affect sporting performance, including:

• fatigue and tiredness
• blurred vision
• problems with concentration
• problems with balance and coordination
• poor motivation and energy
• slower reaction times.

If you have medication side effects that are affecting your daily life and sporting performance, speak to your doctor about reviewing your medications.

If you take up a training program and lose a lot of weight, you may also need to have your medications reviewed as it may affect how your medications are absorbed.

Avoid taking anabolic steroids, as they can have long-term side effects and possibly interfere with antiseizure medication levels in the blood. Some people have reported seizures in relation to anabolic steroid use.

Engaging in physical activities and sports can help prevent or counteract the side effects of some antiseizure medication, such as weight gain or increased fragility of bones.

Exercise-related epilepsy triggers

Seizures that happen during or after exercise may be due to triggers such as:

• extreme fatigue
• lack of sleep
• dehydration (and electrolyte loss)
• hyperthermia (elevated body temperature)
• hypoglycaemia (low blood sugar levels).

Suggestions to help you avoid these triggers include:

• Make sure you take your medication as prescribed.
• Drink plenty of water before, during and after exercise.
• Eat well before exercise and take a light snack or fruit if you need something immediately beforehand.
• Don’t push yourself to the point of physical exhaustion.
• If you’re feeling very hot and tired, slow down or stop.
• Make sure you have at least 2 rest days every week.
• Make sure your diet is nutritionally adequate.
• Get plenty of rest and good quality sleep.
• Limit or abstain from alcohol.

Where to get help

• Your GP (doctor)
• Neurologist
• Epilepsy Action Australia Tel: 1300 37 45 37
• Epilepsy Action Australia have produced animated seizure first-aid videos aimed at both adults and children.
• The National Epilepsy Support Service (NESS) Tel. 1300 761 487 – available Mon to Sat, 9 am to 7 pm (AEST), to provide support and information across Australia. Email: support@epilepsysmart.org.au