Epilepsy

 

Epilepsy is a common condition – 4% of the population will have a seizure at some time in their life and the prevalence of epilepsy is 0.5 – 1% of the population. Defined as a transient electrical disturbance within the brain it leads to varying disturbances in consciousness and bodily function.

Thus, most swimming teachers and coaches will have a swimmer with epilepsy in their class or squad at some time, and in the vast majority of cases fits will be very well controlled with appropriate anti-convulsant medication.

It is important that the coach:-

Be aware of the conditions
Knows what to do if a swimmer has a seizure in the water or poolside
Knows the factors which increase the likelihood of a fit happening in the pool
There is no reason why people with epilepsy can’t enjoy swimming as a hobby or compete at the highest level provided simple precautions are taken. However it is sensible for the person with epilepsy to obtain his/her doctors permission to swim, ensure that control of the fits is optimal and make the pool authorities/coach know that they have epilepsy.

There are many forms of epilepsy classified into partial (no loss of consciousness) and generalised (loss of consciousness) and some common examples are:-

Absences (petit mal) – just a transient lapse in consciousness or awareness lasting a few seconds
Generalised tonic clonic fits (grand mal) – loss of consciousness, fall, tonic (stiffening) phase, clonic (rhythmical jerking), recovery with drowsiness and confusion
Temporal lobe epilepsy – often starts with funny smells, sounds or tastes followed by convulsions
Myoclonic epilepsy – brief muscle jerks

With all there is the risk of drowning and no sufferer from the condition should ever swim alone. From a practical viewpoint this will mean training in an indoor pool with lifeguard facilities and resuscitation equipment. A bright cap in a group can aid identification and it is useful to have a third party e.g. parent on the balcony/poolside to keep and additional eye on the swimmer.

Medication must be declared to doping control

What to do if a swimmer has a fit in the water:

Reach the swimmer as soon as possible approaching from behind if generalised convulsions
Aim to keep the head above water
Once the convulsion is over remove from the water asap
Place in the coma position on poolside to complete the recovery, keeping warm
Resuscitate if breathing has stopped

Factors which increase the likelihood of a fit occurring during swimming:

Overtiredness/over training and fatigue – therefore avoid
Stress
Shimmering lights on the water surface particularly from sunlight or fluorescent lights
Cold water temperatures
Infections/fever – therefore not to swim if inter current viral illness
Hypoglycaemia (low blood glucose) – therefore use glucose replacement drinks during training