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EPILEPSY AND ATHLETICS - 09/09/11

Doi : 10.1016/S0278-5919(05)70061-2 
Robert C. Cantu, MD, FACS, FACSM *

Resumen

At the beginning of spring, the boy ought to be purged and his life ordered as follows: He should rise early and take a moderate walk to the gymnasium … where the exercise would be calculated to warm up the body in order to expel excess material and should aim at strengthening the head and the cardia.5

The Greek physician Galen gave this advice to the father of a child with epilepsy circa ad 180. Likely to be phrased a little differently today, these words remain true for most patients with epilepsy. Modern medicine, however, has not always encouraged physical activity for epileptics.

Little more than 20 years ago, many physicians believed epileptic patients should not enter any sport, let alone collision sports, such as football and hockey. Epilepsy was viewed as “an illness and illnesses require rest.”20 In a 1968 AMA publication it was advised that individuals with “a convulsive disorder not completely controlled by medication” should avoid not only collision (i.e., football and hockey) and contact (i.e., baseball) sports, but even noncontact sports, such as tennis.13 In 1974, the AMA amended its stance, saying epileptics with reasonable control of seizures should be allowed to play any sport except activities where chronic head trauma may occur. In 1983, the American Academy of Pediatrics allowed for further individual consideration and said, “Epilepsy per se should not exclude a child from hockey, baseball, football, basketball, and wrestling.”2

The debate regarding epileptic patients and their participation in sports, especially contact and collision sports, is understandable. Without firm and consistent guidelines nor data from the medical literature, physicians often turned to anecdotal reports. There is growing evidence that most patients with epilepsy benefit from regular exercise. There is little evidence to show that contact and collision sports place epileptics at increased risk for injury compared with athletes without epilepsy. There is substantial evidence that severely limiting a child's participation in physical activities has harmful psychological consequences.

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 Address reprint requests to Robert C. Cantu, MD, FACS, FACSM, Service of Sports Medicine, Emerson Hospital, Concord, MA 01742


© 1998  W. B. Saunders Company. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 17 - N° 1

P. 61-69 - janvier 1998 Regresar al número
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  • RETURN TO PLAY GUIDELINES AFTER A HEAD INJURY
  • Robert C. Cantu
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  • MEDICOLEGAL ASPECTS OF ATHLETIC HEAD INJURY
  • Phillip M. Davis, Maura K. McKelvey

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