Physical Fitness and Exercise in Children and Teens with Epilepsy

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As the new year begins, healthy habits are top of mind. Regular physical activity has benefits for both physical and emotional well-being during adolescence and later in life. However, parents of children with epilepsy or children themselves oftentimes are reluctant to participate in physical activity. The following tips are focused on physical fitness and exercise in children and teens with epilepsy.

What are the physical benefits of regular exercise in children?

Regular physical exercise in children and teens has significant potential to improve health and well-being in adulthood, especially for those with epilepsy.

There is substantial evidence that promotion of regular exercise in children is associated with positive health outcomes in adulthood. Obesity is a growing epidemic. Over one-third of children in North America are either overweight or have obesity. Regular physical exercise has been shown to reduce the risk of obesity, heart disease, high blood pressure, diabetes and osteoporosis. Studies have shown that adults with epilepsy have higher rates of many of these conditions compared with those without epilepsy.

What are the psychological benefits of regular exercise?

Most children enjoy riding their bicycles, team sports, swimming and running. Regular exercise has been shown to have positive effects on mood and self-concept. Additionally, participation in team sports teaches children and teens cooperation and discipline, as well as encourages social interaction with their peers. Whether epilepsy is a factor or not, participation in regular physical activity has beneficial effects on emotional well-being.

Are there special concerns for children with epilepsy?

Parents of children with epilepsy or the children themselves are often reluctant to participate in physical activity for fear that exercise might provoke a seizure. Here are some things to keep in mind:

  • Overheating: Rare epilepsies can be provoked with overheating (Dravet syndrome). But most children with epilepsy can participate in vigorous aerobic exercise, such as running, aerobics, cycling, without an increased risk of seizures. Some medications, such as topiramate or zonisamide, may reduce the body’s ability to sweat, increasing the risk of overheating. People taking these medications should make sure that they keep adequately hydrated when exercising and watch for evidence of overheating (Heatstroke – Symptoms and causes – Mayo Clinic).
  • If you’re sensitive to changing medication times, you may consider continuing to take your medications at your “home time” even when in a different time zone if that’s feasible. In the above example of traveling from North Carolina to Colorado, that would mean taking medication at 7 a.m. and 7 p.m. in Colorado to keep lined up with 9 a.m. and 9 p.m. in North Carolina.
  • If you’re crossing multiple time zones, it may be helpful to gradually adjust the timing of your medication over the first 2 to 3 days of a trip. Discuss time changes with your neurologist if you need help planning when to take your medication while traveling.

How do I pack my medication?

This is an important consideration if you might be separated from your luggage while traveling.

  • Pack medication in a carry-on bag or other luggage that stays with you. Don’t pack medication in checked bags that will not be directly under your control as you travel. That way, if you arrive at your destination and your bags don’t, your medication will be with you. Also, keeping your medication with you makes it easy to take it if you’ll be traveling during your usual dose time.
  • Overbreathing: Some people also worry that overbreathing may result in a seizure. The most common seizure that can be induced by overbreathing is an absence seizure. However, absence seizures occur very infrequently with exercise, as overbreathing in that setting is compensatory for the extra work the body is doing.
  • Contact sports: Many families also worry about contact sports, fearing that a head injury could provoke seizures or that there may be a higher risk of bodily injury. Most children with epilepsy can be encouraged to play contact sports, provided they wear adequate safety gear. Children with vagus nerve stimulators in place should avoid direct contact with these devices.

Certain physical activities may carry higher risks among people with epilepsy.

  • Children and teens with poorly controlled seizures leading to falls should probably avoid activities such as rock climbing or working out on a treadmill, unless very specific safety measures are in place.
  • Water sports require careful supervision because of the risk of drowning. Children and teens should wear a life jacket if boating or swimming in a lake or river. If they are swimming in a pool, a responsible teen or adult should supervise (in addition to the lifeguard on duty), and that person should be close enough to take action in the event of a seizure.
  • Sports such as scuba diving, skydiving, skiing, and barehand rock climbing are best avoided, given the much higher risk of significant injury should a seizure occur.

What does this mean for the typical child or teen with epilepsy?

Participation in regular physical activity is safe for most children and teens with epilepsy and has beneficial effects on both physical and emotional well-being.

  • Appropriate supervision is needed, particularly around water or other higher-risk activities. For many teens, a buddy system with a responsible and educated peer will allow more independence but still adequate supervision for many activities.
  • Team sports should be encouraged, as they promote social interaction. Make sure the coach or supervising adult is aware of the diagnosis of epilepsy, the symptoms of seizures and what to do should a seizure occur.
  • Contact sports are safe for most children, as provoking a seizure with head injury is rare. All children, regardless of whether they have epilepsy, require appropriate safety gear, such as helmets, kneepads and elbow pads.

Learn more about how Mayo Clinic’s epilepsy experts can help manage your epilepsy at MayoClinic.org/epilepsy.


Elaine C. Wirrell, M.D., is the director of Pediatric Epilepsy at Mayo Clinic. She specializes in early-onset epilepsies and epileptic encephalopathies, including West syndrome, Dravet syndrome, myoclonic atonic epilepsy of Doose, Lennox-Gastaut syndrome and CSWS. Her clinical focus also includes early medically intractable pediatric epilepsy, ketogenic diet therapy and surgical therapy for epilepsy.