Epilepsy and exercise

People with epilepsy and their families are often concerned that exercise might trigger seizures, which can lead to overprotection and needless restrictions on activity. In fact, exercise is good for everyone, and it has important benefits for people with epilepsy.

Occasionally a seizure can be triggered by physical exercise, but this is rare. In general, physical exercise does not worsen epilepsy or cause seizures. It can bring positive physical and psychological changes that may improve seizure control through better overall health and wellbeing. Sport and exercise can enhance your quality of life, reduce other or future health issues, and may have a positive effect on how often you have seizures.

Choosing safe activities#

People with epilepsy can safely take part in most sports, as long as they avoid anything that may increase their individual seizure risk, such as overexertion, overheating, dehydration and low blood sugar (hypoglycemia).

• Extra care or caution is needed with sports involving heights, such as some types of gymnastics (parallel bars and uneven bars) or horse riding.
• Someone with epilepsy should never swim alone.
• Sports that involve extreme risk if a seizure happens, such as hang-gliding, scuba diving, downhill skiing, free climbing, and car or motorbike racing, are not recommended.
• Additional limits may be needed for people who have frequent seizures, or whose epilepsy is accompanied by other disabilities.

General safety considerations#

• Avoid your known seizure triggers. For example, if lack of sleep is a trigger for you, get a good night’s sleep before playing sport and avoid exercise when you are overtired.
• Eat something before exercising and stay well hydrated. Take a light snack or fruit if you need something immediately beforehand.
• If heat or becoming overheated is a trigger for you, exercise in an air-conditioned space or at a cooler time of day.
• Do not push yourself to the point of physical exhaustion. If you feel very hot and tired, slow down or stop.
• Do not continue exercising if you feel faint, lightheaded, nauseous or generally unwell, and know your limits.
• Make sure your coach and teammates know what to do if you have a seizure.
• For individual exercise, consider wearing a medical alert bracelet or pendant so others can quickly see that you have epilepsy if a seizure happens.
• Wear protective gear suited to your sport, such as a helmet, and always wear a life jacket for water sports.
• Let family or friends know your walking, jogging or exercise route before you leave, and how long you expect to be out.
• Consider carrying a mobile phone with an ICE (in case of emergency) number listed.

Exercise-related seizure triggers#

Seizures that happen during or after exercise may be due to triggers such as:

• extreme fatigue
• lack of sleep
• dehydration (and electrolyte loss)
• hyperthermia (elevated body temperature)
• hypoglycemia (low blood sugar)

To reduce the risk, make sure your diet is nutritionally adequate, get plenty of good quality sleep, limit or avoid alcohol, and aim for at least two rest days every week.

Medications and exercise#

Always take your medication as prescribed. Antiseizure medications are the mainstay of epilepsy treatment, but some side effects can affect sporting performance, including:

• slower reaction times
• fatigue and tiredness
• blurred vision
• problems with concentration
• problems with balance and coordination
• poor motivation and energy

If medication side effects are affecting your daily life and sporting performance, speak to your doctor about reviewing your medications. If you take up a training program and lose a lot of weight, your medications may also need to be reviewed, as weight change can affect how they are absorbed.

Avoid taking anabolic steroids, as they can have long-term side effects and may interfere with antiseizure medication levels in the blood. Some people have reported seizures linked to anabolic steroid use.

Staying physically active can also help prevent or counteract some side effects of antiseizure medication, such as weight gain or increased fragility of the bones.

Key points#

• Epilepsy is a common condition of the brain in which a person tends to have recurrent unprovoked seizures
• Exercise is good for everyone, but it also has important benefits for people with epilepsy
• In general, physical exercise doesn’t worsen epilepsy or cause seizures

Where to get help#