Dr. Bernard Duchy: “Some epilepsy patients refuse to play a sport they can do well”

Journal: According to certain studies, children and adolescents with epilepsy appear to be more lethargic, gain weight more often, and in worse physical condition than those without the disease. For adults, is it the same?

Dr. Bernard Dochy: Yes, however, poor physical condition is an aggravating factor for epilepsy. It is also better not to gain weight. Work on animal models of epilepsy suggests that physical activity slows the disease. And some studies, even if very rare, indisputably show that between an athlete with epilepsy and a non-epileptic athlete, the stabilization of the disease is much better in the former.

The positive effect is evident with seizure relief, and epilepsy secretions are lower on the EEG, both at rest and after sensitization techniques. While a three-minute deep breath causes distortions to appear or increase, muscle activity accompanied by hyperventilation tends to decrease.

What benefits do you see for the mental health of these patients?

Practicing sports is good for morale and is a reason for patient integration. Autistic epilepsy patients often have a lack of social contact, and are often better on their minds when they are physically active. Unstable patients necessarily suffer from depression due to their illness, which is poorly understood, and often have a deteriorating quality of life. It’s hell to live waiting for a crisis. Physical activity also makes it possible to sleep better and thus avoid some crises that can occur in sedentary patients due to lack of sleep or excessive alcohol intake.

How to choose the type of sport that can be practiced by a patient with epilepsy?

The International League Against Epilepsy was concerned with the problem and classified sports into three categories. Sports that any person with epilepsy can engage in, even if he is unstable, such as team sports or racquet sports, those that are slightly more sensitive, and other sports that can be considered dangerous, and sometimes fatal to the patient.

The league put some organization into something that was very vague and prior to this classification every neurologist acted in his corner according to his common sense which wasn’t always the case. Some bans weren’t justified at all, and this initiative opened some doors… I was sometimes asked a question: “My son plays football, he will turn heads, is he dangerous?” I would answer: “No, it has nothing to do with it.” It cannot cause seizures. Even in rugby, connectivity is not an issue. Judo and wrestling are allowed. The occurrence of a crisis during a judo session does not lead to consequences. In athletics, everything is permitted, except for pole vaulting.

In general, seizures during sports are not dangerous and the benefit will be greater in any case.

But what about swimming?

Swimming, which is in group 2, can indeed be a cause for concern. I had two patients who almost drowned because they were not supervised, one of them was in intensive care. To be able to swim, the patient should not have recurrent seizures and should be relatively stable and controlled.

Some patients, out of ignorance, refuse to play a sport that they can play, which is a very harmful sport. But it is always necessary to inform the escorts. On the other hand, I’ve had patients who have been surfers, which is totally not recommended, except perhaps for patients who have been cured or stabilized for many years. But I wouldn’t let my epilepsy go it alone with his board, it’s risky. Like going on a boat alone.

Did you have any doubts about any particular case?

I’m all for the sport. I even let a well-stable patient who hasn’t had a seizure in years go parachute. It was his dream. What an idea! I had cold sweats. Fortunately, everything went well. He jumped with his coach, and was overjoyed. But it was a special circumstance … What is also important is to consider whether the sport is aerobic or not. Experimental studies showed that aerobic exercise was somewhat positive and that it was necessary to avoid strenuous anaerobic sports as much as possible. Thus, embarking on a marathon would not necessarily be wise…on the other hand, running is not a problem.

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