Seizures and diving

[mikecable66]

This is a catch 22. I had a seizure while working out several months ago. I've never had a seizure before or since. There has been no clear evidence of what caused the seizure just a lot of speculation. I couldn't drive for several months until it was fairly certain that it wouldn't happen again. I now have my driving rights reinstated. I haven't been given any special instructions about going on with my life. I am currently under medication that is supposed to help prevent any more seizures. I am looking into a dive charter and I don't know how honest to be with them. If I tell them I could be at risk for a seizure, are they going to keep me from diving? Wouldn't the dive master like to know if one of his divers is at risk? If I ask my neurologist about it, do I risk him keeping me from diving just to protect his practice? I'm 45 years old and have never had a seizure until the one 6 months ago. What do you do? I want to dive and I want to dive safely. I'm not looking to go behind any ones back, but everyone has to cover their a##.

 

[TSandM]

Wow -- this is a difficult one. In Washington State, you lose your driving privileges for at least six months after a seizure. So I assume you had a single seizure, and have had no recurrence in six months? If you were off meds, I might say you are cleared to try diving. But on meds? We really don't know what is going on in your brain at all. Elevated oxygen tensions are known predispositions for seizures, and someone with a seizure focus should not be subjected to anything that lowers the seizure threshold, let alone something that does that in a setting where a seizure is likely to be lethal.

If you ask your neurologist, he is going to be very conservative -- not only because he doesn't want to face a lawsuit, but because honestly, like most physicians, he does not want to advise you that it's okay to do something that could result in your death.

If you were six months, OFF MEDS, seizure free, and had only had the one ever, with no identified predisposing factors (like head trauma or a stroke) I might clear you. But I will warn you that I am rather liberal, and other physicians and medical institutions are far more conservative and cautious.

 

[mikecable66]

It's not likely the Dr. will ever take me off the meds, is it?

 

[sphyrnidus]

Well, I don't know about US policy, but in Europe you'd not be treated after one seizure. And certainly everybody that we treat for epilepsy is taken off medication after two years, to see what happens.
So the first thing would be to know, why you have been put on med. in the first place and what the diagnosis is your neuroligist made.

 

[Duke Dive Medicine]

I don't think I could say anything that TSandM hasn't already said. Given the information you provided, it's highly unlikely that we would clear you to dive. If the etiology of the seizure isn't known, you don't know what the risk of having another one is. Also, it's hard to know whether the medication you are on will prevent another, especially with the diving factors that TSandM mentioned.

Best regards,
DDM

 

[TSandM]

I'm actually quite surprised that you are on meds after a single seizure, unless you had an abnormal EEG. We generally don't start antiseizure meds after one episode.

 

[otis24]

I've been seizure free and off meds for 18 years. Before that I had about 4 dozen seizures over the span of 9 yrs. I've been diving for a while now

I'd say be very conservative. I have a lot of scars on my head from hitting the ground. Having a seizure under water would be real bad. Just be careful!

 

[tomfcrist]

I'm actually quite surprised that you are on meds after a single seizure, unless you had an abnormal EEG. We generally don't start antiseizure meds after one episode.

This is what I was thinking too. I'd say the "to dive or not to dive" is dependent on if you had A seizure, or if you have epilepsy.

 

[Duke Dive Medicine]

This is what I was thinking too. I'd say the "to dive or not to dive" is dependent on if you had A seizure, or if you have epilepsy.

That's a good point, provided that he can figure out why he had the seizure and the etiology/provocation for the seizure is mitigated to the point where there is a high degree of certainty that he won't have another one. There may be some details that the OP hasn't shared, but to me it looks like his health care team could not determine the cause of his seizure and put him on anti-seizure medications in the hopes that it won't happen again. I don't know that I would pin my safety, and that of my potential rescuers, on that hope.

Best regards,
DDM

post script: I got Dr. Moon and Dr. Stolp in the same room together and asked them about this case. The consensus was to stay out of the water for a minimum of five years. Dr. Moon's caveat after that was, "It depends on how risk-averse you are" to which Dr. Stolp responded, "Don't forget about the dive buddy".

 

[mikecable66]

I don't have epilepsy. They located a small tumor in my head. Very, very, very small. They suspect this is the reason for the seizure. The seizure could have been triggered by many, many things. The tumor could have been in place for decades and I've been diving the entire time. For me it comes down to this, if I can drive a car on the interstate, rock climb, horseback ride, ride roller coasters,...can I dive?