Unfortunately, people with epilepsy (PWEs) are often advised against participating in sports due to fear the activity will worsen seizures or cause injury. We asked students at elementary, high school and university levels about their experiences with having epilepsy and participating in individual and team sports.
Why should people with epilepsy participate in sports?
Sports allow students to spend time with their friends, family and community while getting exercise. Team sports encourage participants to work hard to improve their performance, to be successful during games and to earn a starting position on the team. Players can enjoy the camaraderie that comes with winning, which they describe as “an amazing experience because you know that team members gave their best and it paid off.” Individual sports allow students to improve their skills and strengths as they compete for new records.
Sports participation provides students with challenges that are different from those they face in the classroom. Many people with epilepsy have learning and developmental disabilities, which can affect self-worth and peer interactions. Sports are a way to move beyond these disabilities. As one student-athlete says, “Being successful in sports helps me forget the boundaries that epilepsy has given me in the classroom.”
What challenges have you experienced managing epilepsy and competitive sports?
All student-athletes have the challenge of carefully managing time to ensure they are keeping up with schoolwork, especially during peak competition times. This is a particular challenge for athletes with epilepsy. While other students can “push through” challenges to their bodies, if those with epilepsy do so, they risk having their seizures worsen.
Having epilepsy requires student-athletes to ensure they take their medications on time, even when games run late. This means they may need to take medications during a game — and potentially sedating medications can affect athletic performance. These athletes also need to avoid sleep disruption. So they may need to arrange class schedules to ensure sufficient sleep at night, especially after a late game. When the team goes out after games, those with epilepsy may need to go home to sleep.
One of the most challenging aspects of epilepsy is the unpredictability of seizures. Student-athletes must go into competition focused on their sports but always knowing they could have a seizure during competition. Not only do students miss playing time due to seizures but seizures also can be embarrassing for the athlete and concerning for coaches and teammates. Without sufficient education, coaches can be anxious to allow athletes with epilepsy to travel with the team — or participate at all. Rescue medications, and someone trained to administer them, always need to be with the athlete.
Are there any sports that PWEs should avoid?
The International League Against Epilepsy classifies sports into three risk groups. Group 1 comprises sports that have no additional risk to participants or bystanders. Examples are bowling, baseball, basketball, football, cross-country skiing and wrestling. In group 2 are sports with moderate risks to people with epilepsy but not to bystanders. These are sports such as archery, pole vault, fencing, gymnastics, swimming, cycling, and others. Group 3 is for sports with high risk to people with epilepsy and possible risk to bystanders. These sports include aviation, climbing, diving, motor sports, parachuting, surfing, scuba diving and similar sports.
Per recommendations from the International League Against Epilepsy, those who are seizure-free for one year can participate in all sports, and those with continuing seizures can play all group 1 sports and some group 2 sports at their neurologists’ discretion. Participation in group 3 sports that could pose a danger to others should be avoided. Some group 3 sports can be considered with appropriate surveillance and supervision.
What advice would you give to other people with epilepsy who want to be competitive athletes?
The overwhelming advice from our athletes is to do it. Epilepsy should not hold back anyone who wants to participate in sports. Consult with a health care professional before engaging in any sports activity and discuss any challenges that occur. Those with epilepsy will need to adapt to new environments and very carefully manage their time. They should have good and honest relationships with their coaches, teammates and teachers to prepare them to help if a seizure occurs. Do not try to hide if you have epilepsy.
All athletes should take safety precautions to reduce the risk of injury or seizure breakthrough. However, just as it is for athletes without epilepsy, there is no way to eliminate all risks. Seizures can occur, even when all risk factors are controlled. If a PWE wants to participate, they should not delay. One of the student-athletes with epilepsy said it best: “If you wait to pursue your athletic dreams until it’s ‘completely safe,’ then you won’t ever get to achieve them. I live every day with epilepsy and other conditions that are considered ‘life-limiting,’ but if the number of years I get to live is going to be limited, then I am for sure going to spend them pursuing all my biggest dreams!”
Learn more about epilepsy and care available at Mayo Clinic.
Katherine C. Nickels, M.D., is a neurologist at Mayo Clinic and the Mayo Clinic Children’s Center. She specializes in pediatric and adolescent medicine and the treatment of epilepsy and seizures, especially absence, febrile, frontal lobe and grand mal seizures.
Capovilla G , et al. Epilepsy, seizures, physical exercise, and sports: A report from the ILAE Task Force on Sports and Epilepsy. Epilepsia. 2016:57;6.