Epilepsy and Seizures

  • Jorge Roberto PaguraEmail author
  • Rudá Alessi


Epilepsy is a brain disorder which has caused stigma for long, especially in group activities.

In the last decade, however, a number of studies have shown that epilepsy patients must be socially integrated. They recommend sports practice as greatly beneficial, not only for its social integration but also for its help in crisis management.

Through the development of new medications, which enhanced crisis management significantly, the participation of epilepsy patients in sports practice has increased.

However, it is clear that some sports, especially with strong physical contact, must be avoided. And even sports with possible contacts, though allowed, must follow monitoring standards with specialists following the recommended protocols, so that they can practice sports more safely. Also, it should be considered that seizures are nonspecific manifestations of pre-existing brain damage and they can occur with metabolic and traumatic changes, which does not mean a state of epileptic disease.

For high-performance sports, control through specific medications is a safety factor and can be widely used, since the antiepileptic drugs are not included in the forbidden list by WADA (World Anti-Doping Agency).


Epilepsy Seizures Epilepsy in sports Athlete with epilepsy 


  1. 1.
    Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46(4):470–2.CrossRefGoogle Scholar
  2. 2.
    Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475–82.CrossRefGoogle Scholar
  3. 3.
    Luders H, Acharya J, Baumgartner C, et al. Semiological seizure classification. Epilepsia. 1998;39(9):1006–13.CrossRefGoogle Scholar
  4. 4.
    Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia. 1993;34:453.CrossRefGoogle Scholar
  5. 5.
    Everitt P, Sander JW. Incidence of epilepsy is now higher in elderly people than children. Br Med J. 1998;316:780.CrossRefGoogle Scholar
  6. 6.
    Schwartzkroin PA. Mechanisms of epileptogenesis in symptomatic epilepsy. In:The causes of epilepsy. Cambridge: Cambridge University Press; 2011.Google Scholar
  7. 7.
    Reinert M, Khaldi A, Zauner A, et al. High level of extracellular potassium and its correlates after severe head injury. J Neurosurg. 2000;93:800–7.CrossRefGoogle Scholar
  8. 8.
    Gorji A, Speckmann EJ. Spreading depression enhances the spontaneous epileptiform activity in human neocortical tissues. Eur J Neurosci. 2004;19:3371–4.CrossRefGoogle Scholar
  9. 9.
    Benardo LS. Prevention of epilepsy after head trauma: do we need new drugs or a new approach? Epilepsia. 2003;44(10):27–33.CrossRefGoogle Scholar
  10. 10.
    Nizuma K, Endo H, Chan PH. Oxidative stress and mitochondrial dysfunction as determinants of ischemic neuronal death and survival. J Neurochem. 2009;109(1):133–8.CrossRefGoogle Scholar
  11. 11.
    Pitkanen A, Karatishvili I, Karhunen H. Epileptogenesis in experimental models. Epilepsia. 2007;49(5):19–25.Google Scholar
  12. 12.
    Scheffer IE, Berkovic S, Capovilla G, et al. LAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512–8.CrossRefGoogle Scholar
  13. 13.
    Fisher RS, Cross JH, French JA. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):522.CrossRefGoogle Scholar
  14. 14.
    Beghi E, Carpio A, Forsgren L, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010;51(4):671.CrossRefGoogle Scholar
  15. 15.
    Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69(21):1996.CrossRefGoogle Scholar
  16. 16.
    van Donselaar CA, Schimsheimer RJ, Geerts AT. Value of the electroencephalogram in adult patients with untreated idiopathic first seizures. Arch Neurol. 1992;49(3):231.CrossRefGoogle Scholar
  17. 17.
    Fountain NB, Van Ness PC, Swain-Eng R, et al. Quality improvement in neurology: AAN epilepsy quality measures: report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology. Neurology. 2011;76(1):94.CrossRefGoogle Scholar
  18. 18.
    ACEP Clinical Policies Committee, Clinical Policies Subcommittee on Seizures. Critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2004;43(5):605–25.CrossRefGoogle Scholar
  19. 19.
    Capovilla G, Kaufman KR, Perucca E, Moshé SL, Arida RM, et al. Epilepsy, seizures, physical exercise, and sports: a report from the ILAE task force on sports and epilepsy. Epilepsia. 2016;57(1):6–12.CrossRefGoogle Scholar
  20. 20.
    Jalava M, Sillanpaa M. Physical activity, health-related fitness, and health experience in adults with childhood-onset epilepsy: a controlled study. Epilepsia. 1997;38(4):424–9.CrossRefGoogle Scholar
  21. 21.
    Collard SS, Ellis-Hill C. ‘I’d rather you didn’t come’: the impact of stigma on exercising with epilepsy. J Health Psychol. 2017:1359105317729560.Google Scholar
  22. 22.
    Ellis MJ, Ritchie L, Essig M, Ng M, Tamayo A, Serletis D. Management and return to play considerations in an Elite hockey player with temporal lobe epilepsy. Curr Sports Med Rep. 2018;17(1):10–2. Scholar
  23. 23.
    Sahoo SK, Fountain NB. Epilepsy in football players and other land-based contact or collision sport athletes: when can they participate, and is there an increased risk? Curr Sports Med Rep. 2004;3(5):284–8.CrossRefGoogle Scholar
  24. 24.
    Frey LC. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003;44(Suppl 10):11–7.CrossRefGoogle Scholar
  25. 25.
    Haltiner AM, Temkin NR, Dikmen SS. Risk of seizure recurrence after the first late posttraumatic seizure. Arch Phys Med Rehabil. 1997;78:835–40.CrossRefGoogle Scholar
  26. 26.
    Chen JW, Ruff RL, Eavey R, Wasterlain CG. Posttraumatic epilepsy and treatment. J Rehabil Res Dev. 2009;46(6):685–96.CrossRefGoogle Scholar
  27. 27.
    Schachter SC. Advances in the assessment of refractory epilepsy. Epilepsia. 1993;34(Suppl 5):S24.CrossRefGoogle Scholar
  28. 28.
    Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001;42(10):1255.CrossRefGoogle Scholar
  29. 29.
    Brodie MJ, Perucca E, Ryvlin P. Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. Neurology. 2007;68(6):402.CrossRefGoogle Scholar
  30. 30.
    Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314.CrossRefGoogle Scholar
  31. 31.
    Bonnett LJ, Tudur Smith C, Donegan S, et al. Treatment outcome after failure of a first antiepileptic drug. Neurology. 2014;83(6):552–60.CrossRefGoogle Scholar
  32. 32.
    Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010;51(6):1069.CrossRefGoogle Scholar
  33. 33.
    Labiner DM, Bagic AI, Herman ST, et al. Essential services, personnel, and facilities in specialized epilepsy centers—revised 2010 guidelines. Epilepsia. 2010;51(11):2322.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  1. 1.Neurosurgery, ABC Medical School—FMABCSanto AndréBrazil
  2. 2.Brazilian Neurosurgical SocietyParaísoBrazil
  3. 3.Medical and Antidoping control-Brazilian Soccer Confederation (CBF)Rio de JaneiroBrazil
  4. 4.Neuroscience DepartmentABC Medical School—FMABCSanto AndréBrazil
  5. 5.Laboratory of Clinical NeurophysiologyInstitute and Department of Psychiatry, University of Sao Paulo—USPSão PauloBrazil

Personalised recommendations