Epilepsy and Exercise - Relationship, Adverse Effects, and Safety Guidelines

Introduction

Physical activity is extensively covered as a supplementary treatment to reduce seizure susceptibility and improve the quality of life in people with epilepsy. People with epilepsy can participate in a particular activity. It is essential to take into account the type of sport, the type and severity of the seizures, seizure precipitating factors, the typical timing of seizure occurrence, and the person's attitude toward accepting some level of risk. As a non-pharmacological method, exercise or athletic involvement can be combined with regular epilepsy therapy.

What Is Epilepsy?

The neurological condition of epilepsy is characterized by abnormal brain activity that results in seizures or episodes of strange behavior, feelings, and even loss of consciousness. This can develop due to a genetic condition or a traumatic brain injury or stroke; the triggering factors include missed medicine, lack of sleep, stress, alcohol, alcohol consumption, prolonged fasting, physical overtiredness, and menstruation. However, stress-induced seizures are easily avoided through sports and exercise.

What Causes Epilepsy During Exercise?

Exercise-induced seizures occur during running, stationary cycling, or playing collective sports activities. The triggering or precipitant factors related to exercise are hyperthermia, hypoglycemia, hyponatremia, hypoxia, hyperventilation, fatigue, and stress from the competition.

• Hyperthermia: Rarely, long-term exercise-induced hyperthermia (fever) is accompanied by a decrease in cerebral blood flow. Fever is the most frequent cause of seizures in children and infants; hence it has been postulated that prolonged activity in highly humid and hot settings puts a person with epilepsy in danger of hyperthermia. Additionally, utilizing blood glucose and oxygen also decreases the blood histamine level.

• Hypoglycemia: Seizures may be triggered by prolonged exercise-induced hypoglycemia. Decreased glucose levels in epilepsy patients might change neural or brain function. People with type one diabetes mellitus occasionally experience hypoglycemia seizures.

• Hyponatremia: Homeostasis of the electrolytes is essential for proper brain function, and any imbalance can result in seizures. Exercise-associated hyponatremia is characterized by low blood sodium levels that occur during or after physical activity, followed by a hemodilution. It is considered the leading risk factor for hyponatremia.

• Hypoxia: Hypoxia is not evident in exercise; it can happen during high-altitude sports like skiing or rock climbing. Stimulating peripheral chemoreceptors in hypoxia causes hyperventilation, which results in respiratory alkalosis and may ultimately cause seizures.

• Hyperventilation: Hypoxia reduces cerebral blood flow and hyperventilation (a reduction in arterial carbon dioxide partial pressure). However, increased ventilation during exercise or sports is a physiological demand in response to respiratory alkalosis and metabolic acidosis.

• Fatigue: Physical and emotional exhaustion can result from sports or physical activity. For example, football or soccer induce more stress on the brain than other sports activities.

• Stress: It is a common precipitating factor of epilepsy. The mental focus during competitive sports has a higher risk of inducing seizures.

What Is the Relationship Between Epilepsy and Exercise?

Everyone benefits from exercise, but those with epilepsy also greatly benefit from it. Epilepsy is triggered by stress, which can be easily avoided through sports and exercise. Rarely, physical activity can cause seizures. Practice doesn't make epilepsy worse, but it can help seizure management by enhancing general health. The majority of sports are safe for people with epilepsy to play. There is no evidence that even contact sports may cause seizures. If seizures are well-controlled and a direct supervisor is present, participating in water activities is likewise safe. Only the sports requiring heights require extra attention or care, such as horseback riding and several forms of gymnastics, such as parallel bars and uneven bars. It is best to avoid overexertion, dehydration, and hypoglycemia (low blood sugar), as these conditions might raise the possibility of having a seizure.

What Is the Role of Exercise in Reducing Comorbidities From Epilepsy?

Epilepsy is linked to a higher risk of psychiatric and medical comorbidities. Depression and anxiety are frequent co-morbidities that can affect the quality of life. Epilepsy, recurring episodes of seizures, using anticonvulsant drugs, or a combination of these variables may lead to mental abnormalities. The exercise decreases stress, thereby reducing seizure vulnerability and, as a result, a drop in epilepsy comorbidities. Additionally, some anticonvulsant drugs might lead to obesity and reduced bone density, but regular exercise can minimize these harmful effects and improves bone stability.

What Is Exercise's Role in Managing the Adverse Effects of Antiepileptic Drugs?

The core of epilepsy therapy is antiepileptic medicine, although some of the side effects may have an impact on athletic performance. Avoid using anabolic steroids (synthetic artificial versions of testosterone) since they may have long-term adverse effects and may affect the blood levels of antiepileptic drugs. In addition, seizures have been linked to the use of anabolic steroids by some individuals.

The common side effects are

• Fatigue.

• Tiredness.

• Poor concentration.

• Altered the balance and coordination.

• Obesity.

• Blurred vision.

• Decreased bone density.

Sports and physical activity can help to avoid or offset some antiepileptic drug adverse effects, such as weight gain or increased bone fragility.

What Are the Safety Guidelines for Exercise to Avoid Epilepsy?

General safety considerations may include the following

• Stay aware of epilepsy-triggering factors and avoid those activities.

• Stay away from exercise when physically or mentally overtired.

• Stay well-hydrated by drinking plenty of water.

• Have some food before working out.

• Get good sleep before engaging in any physical activity.

• Be aware of your limitations and avoid over-practicing.

• Inform both a teammate and a coach about the medical condition.

• Exercise in an air-conditioned facility when heat is the triggering factor of epilepsy.

• Wear a medical alert necklace or bracelet for seizures.

• Wear a life jacket at all times when participating in water activities.

• Wear safety equipment related to appropriate sports, including a helmet.

• A cell phone with an "ICE" (in case of emergency) phone number should be carried.

• Carry medication to avoid endurance.

Conclusion

Although abdominal injuries in sports are uncommon, when they do happen, it's critical that the doctor recognizes the warning indications of potentially fatal damage to the liver, spleen, or hollow abdominal viscera. Even though the sports medicine doctor may not always be able to treat many of these illnesses effectively, he or she should be knowledgeable about the best diagnostic techniques and current therapeutic alternatives. Making judgments on return to play require this information, which is crucial for properly participating in treatment decisions. Exercise has been utilized successfully as an additional type of epilepsy therapy. Exercise knowledge might improve the quality of life for people with epilepsy. However, several nonpharmacological strategies have often been used as adjunctive therapies for epilepsy.