Can I dive?

[bonnie]

About 18 months ago I had my first epileptic fit. I am 39yrs old and had never experienced a siezure before. A significant factor relating to this fit appears to have been stress. I have not had any repeat suggestion of a siezure and now want to scuba dive. I am not on medication and have my driving licence. Could you please give me your opinion on this?

Regards

Bonnie

 

[The Iceni]

Bi Bonnie,

Epilepsy is an absolute contraindiaction to diving, I'm afraid and I very much doubt that any doctor would certify you as fit to dive.

This is because a fit underwater is almost always fatal and the risk of an epileptic experiencing a fit when diving is greatly increased by the alien environment to say nothing about the sedating effects of your medication.

I wish I could have given you better news.:doctor:

 

[bonnie]

I am not on medication

 

[Drew Sailbum]

My sister has epilepsy, and I have a decent layman's understanding.

Dr Thomas is absolutely right that epilepsy is an absolute contraindication to diving. Whether medication is required or not is not the issue. It is also irrelevant whther you had a tonic-clonic (grand-mal) or petit mal seizure.

That said, if you have only ever had one seizure, then I would suggest discussing with your neurologist how the diagnosis of epilepsy was made. There are a few other conditions that can cause an apparent "fit" but which are not epilepsy.

When my sister had her first seizure, her doctor would not diagnose epilepsy until confirmation by EEG of abnormal brainwave activity. That was easily obtained in her case since she had a second seizure while the neurologist was evaluating her.

I do not know whether my sister's doctor represents the "norm" or not in terms of the evidence he wished to see to make that diagnosis.

 

[The Iceni]

Sorry Bonnie if you took my post personally and felt I had misread it.

I was only giving you general advice in reply to your post on "epileptic fits". I really wonder if you did in fact have a epileptic fit?

It sounds like it may have been something else in which case you are not "epileptic" and may indeed be fit to dive but, with respect, this forum is not the place to determine that! I would strongly recommend a neurological opinion because of the dire consequences of an underwater fit, whatever the cause.

I suppose I should have been a little more inquisitive and a lot less pedantic since if you are not on medication I find it hard to understand where the diagnosis of an "epileptic fit" comes from.

Most authorities allow normal adults to have more than one "fit" before the possibility of epilepsy is considered. Not all convulsions are epileptic, i.e caused by a confirmed brain disorder. For instance very young children can suffer febrile convulsions.

As for medication, what I was saying that you cannot make an epileptic safe to dive simply by starting or increasing their medication.

I do hope your neurologist gives you the go-ahead.

 

[bonnie]

I will now investigate if I am considered epileptic with the neurologist that saw me following the scans. I know that this is not the place to determine if it was an epileptic fit but your replies have allowed me to get a different perspective on things.

Thanks again

I will let you know the outcome

 

[DocVikingo]

Hi Bonnie,

Sorry to hear about this.

As Dr. Thomas indicated, it is important to establish the existence of a bona fide seizure disorder. In this regard, a number of sets of diagnostic criteria by authoritative bodies require at least 2 confirmed seizure events before the diagnosis legitimately can be assigned.

However, the statement that "Not all convulsions are epileptic, i.e caused by a confirmed brain disorder," may be misleading. (BTW, those age 39 with adult onset of seizures generally will not find the matter of febrile convulsions in young children to be germane.)

According to the American Academy of Neurology, American Neurological Association & other world recognized bodies with an interest in the diagnosis & treatment of epilepsy, this disorder is diagnosed on the basis of the patient's medical & family history, and detailed descriptions of the seizure events by the patient & others who have witnessed them.

While there is the strong presumption that epilepsy is caused by underlying pathology of brain, and laboratory findings can be of great use, the diagnosis does not require confirmation by abnormal findings on brain imaging (e.g., CT, MRI, PET), electroencephalography (EEG) or other such techniques. In fact, it is generally conceded that in about 70% of confirmed cases of epilepsy no known cause is ever determined despite exhaustive evaluation.

As a general orientation to the issue of diving with epilepsy, you might wish to see my post within this recent thread from the board achives-->http://www.scubaboard.com/showthread.php?threadid=4848&highlight=epilepsy.
You may find the information in the last paragraph about British Sub-Aqua Club clearance to dive criteria of especial interest given statements you may have heard regarding a history of epilepsy always being an absolute contraindication to scuba.

This agency is quite influential in medical decisions regarding fitness to dive in Dr. Thomas' country. I believe that it is BSAC Medical Standard # 3 that contains the criteria mentioned. Of course, this may be of limited assistance if you live in a country that tends to follow different standards.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such. Any decisions about your return to diving will be determined between you & your physician.

Best of luck.

DocVikingo

 

[AllenG]

Bonnie - Sorry to read of your recent experience. I would encourage you to check with a neurologist re diagnosis before even considering the issue of diving. Although epilepsy can strike at any age, the combination of (1) middle age (Sorry Bonnie! I should be reticent to describe an energetic 39 y.o. looking to start diving as "middle aged," but I don't have a better phrase!) onset, (2) the treating neurologist's decision to pass on pharmacological treatment, (3) a single episode, and (4) 18 months without further episodes suggests that the diagnostic picture may not be set. Am I suggesting you don't have epilepsy? Heck no! I am suggesting that a physician could not positively diagnose or rule out epilepsy given those four points and our venerable ScubaBoard physicians are therefore not in a position to provide you with meaningful information on the risks of diving with the reported symptoms. You need to go back to your neurologist (or a second neurologist if necessary) to get more definitive information on your condition itself (what did the EEG show; is it in fact epilepsy; if not definitely epilepsy, what else might it be . . . ). Good luck to you.

And for the same nickel, thanks to our ScubaBoard physicians for taking the time to tease out the issues and providing the technical details from which divers with medical conditions can make informed opinions!

 

[devjr]

You are going to need a bone fide Hail Mary pass to make it to the goal line and get certified.

The docs' already explained the ramifications including the fact that in many cases of seizure, there is no definitive cause discovered. It's defined as epilepsy if certain points are met. Regardless of what you call it, the risk to a person in the water, is extreme. One of Mark Twain's daughters, Jean Clemmens, was epileptic. She drowned while taking a bath.

Unless you had a one time reaction to a fever or drug, you are pretty much cooked. Even then, you will probably have to submit a medical history. There will be a question like, "have you ever experienced a seizure or blackout?" What will you do then?

 

[sharpenu]

That is not always the case. I know divers who have been cleared by doctors to dive for all sorts of medical conditions, including seizures. One particular diver that I am aware of has a seizure condition that requires medication (dilantin) If I were you, I would find a doctor in your area that specializes not only in neurology, but in diving related issues (if one is available) It may be that the doctor in question will clear you.