6, Issue 9 September 2010
It's September and that means back to school. One of the classic rites of back to school passage is the return of fall sports, particularly those involving football, the winding down of the baseball season and other sports that take center stage. Along with the excitement that school sports bring, there can also be sidelining disappointments in individuals with epilepsy especially if well meaning administrators use seizures as a barrier to prohibit participation in these after school activities in the name of safety. Invariably, the question arises of how should individuals with epilepsy be counseled with regards to exercise and sports participation? Do the benefits of exercise outweigh the potential risk from participating in a given sport? Are there any activities that one must not allow individuals with seizures to partake? These questions are important and can fundamentally impact the quality of life for thousands of individuals.
On any given day there is a newspaper article, a magazine column or some press clipping telling us that we need to increase our exercise time due to the rampant obesity epidemic in the United States. Individuals with seizures and epilepsy are often caught in the middle of conflicting messages on the topic. On one hand, exercise is encouraged and on the other, certain outdoor activities are discouraged due to potential dangers. There is some good news to report. Studies have shown that exercise may possess antiepileptic properties. That is, exercise in its own right may be able to reduce seizures. Even if a seizure were to occur, the risk is reportedly highest during the cool-down period immediately post exercise and not during the activity. However, the few studies reviewing this topic have not given precise answers on the issue. Curiously, exercise is a common activity utilized in epilepsy monitoring centers to help encourage seizure recording, yet it actually may have the opposite effect if performed on a consistent basis. Clearly, this is a complex subject and more research is needed in order to understand it.
If one accepts that exercise is a helpful and necessary part of life then how individuals with seizures should be counseled about playing sports, which is a common way in which many people exercise. The risk of an injurious seizure during an activity is going to depend on the type of seizure. Generalized tonic-clonic or atonic seizures are more likely to cause a problem than a simple partial event. There are some hard and fast generalities that can help guide individuals with regards to participating in sports. Contact sports generally do not provoke more serious seizures; however, one has to be cautious about the potential for head injuries and concussions. Recently, concussions have received considerable media attention. A concussion in someone with epilepsy can potentially trigger more events. Therefore, taking the necessary safety precautions are essential to prevent problems. Special considerations also need to be made with regards to water based sports. It is never safe to assume that because a person has seizures means that they must be banned from participating in any type of competitive sports. Rather, common sense should rule the day.
In this month's Hallway Conversations, we will explore the topic of sports, exercise and epilepsy. Dr. Nitin Sethi from the Weill Cornell Medical Center will join us to discuss this issue, what we know about the research and what should we as health professionals be counseling our patients with regards to this topic.
Later in the month of September, Dr. Carl Bazil from the Columbia Presbyterian Medical Center will be discussing potassium channel antagonists on a special Hallway Conversations pertaining to this new class of antiepileptic drugs. Over the summer, a new agent, Retigabine, was recently evaluated by an advisory panel which voted to recommend approval of this agent by the FDA. The final FDA ruling on this first of class drug has yet to be rendered. Dr. Bazil will help to illuminate how these drugs work, what seizure types they might control and what are their potential side-effects.
We hope that you find these topics helpful and useful. We also hope you join us on Hallway Conversations or throughout our various content platforms on Epilepsy.com.
MARK YOUR CALENDAR
Upcoming grant cycles, epilepsy-related Hallway Conversations, conferences, symposia, and events include:
Hallway Conversations for September
Monday, 9/20/10 3:30pm EST
Guest: Carl W. Bazil, M.D., Ph.D. Caitlin Tynan Doyle Professor of Clinical Neurology Director, Epilepsy and Sleep Division Columbia University College of Physicians and Surgeons
Monday, 9/27/10 9am EST
Guest: Nitin Sethi, MD Assistant Professor of Neurology New York-Presbyterian Hospital Weill Cornell Medical Center
Topic: Seizures and Sports
September 23-25, 2010
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ACCELERATION – 2009 ANNUAL REPORT
The Epilepsy Therapy Project's mission is to make new treatments a reality – rapidly for the 50 million people throughout the world and the 3 million people in the U.S. living with epilepsy and seizures.
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