Diving and Epilepsy

[TexasMike]

A friend of mine is a huge fan of the water. Many is the time he is either in the pool, swimming in the lake, or water skiing. But I only recently found out he hasn't had a chance to breath underwater.

When I asked why not, he told me that he always wanted to, but he has epilepsy and the doctors he has seen won't sign of on him doing scuba.

Can some of the Docs and other knowledgeable folks help me understand why he's prevented from diving?

I know one obvious reason is if he had an episode underwater the chance of drowning is there, but what else would keep him from getting below the surface?

 

[carlislere]

Mike,
Isn't that enough reason? I have been called to numerous epileptic seizure calls when I was with a volunteer FD and they have no control over themselves at all. Drowning is very likely.

 

[DocVikingo]

Evening Texas Mike,

Here's an edited version of an article I wrote for "Rodale's Scuba Diving" early last year:

"While medical nemeses such as diabetes and asthma have recently become subject to clearance to dive under conditions of proper control, seizure disorder has not fared as well. PADI, DAN and other major dive organizations continue to view adult epilepsy, controlled or not, as precluding scuba. Certain types of early childhood convulsions can be medically excused, but it is mandatory that a potential diver with such a history have a completely normal neurological examination.

This rankles many of those desiring to dive who have only a distant history of seizure and are not on anticonvulsants, or are well or completely controlled by medication.

The reason for the prohibition is that an epileptic event underwater can have fatal consequences, and can occur even in those long seizure-free or well-controlled on medication.

While there are numerous types of seizure disorder, nearly all involve both motor dyscontrol and an alteration of consciousness, in varying degrees of severity. In the most serious forms, consciousness is lost and a major motor convulsion occurs.

During such a serious event, loss of the second stage is almost certain and this could result in drowning. Furthermore, breath holding can be occasioned by spasmodic phases of the motor activity. This increases the risk of pulmonary barotrauma during attempts to bring the stricken diver to the surface.

Even when the seizure does not involve unconsciousness and significant motor dyscontrol, the disturbances of awareness can be life-threatening.

Finally, seizure medications, to a greater or lesser extent, have sedative side effects and could exacerbate nitrogen narcosis or cause its appearance at shallower than expected depths.

The outlook overseas is somewhat rosier for those with a history seizure disorder who are not currently on medication. The British Sub-Aqua Club (BSAC), for example, suggests requirements for medical clearance to dive that include five years free from a convulsion off medication, reduced to 3 years when the convulsions were exclusively nocturnal."

Hope this clarifies the matter somewhat.

Happy holidays.

DocVikingo

 

[TexasMike]

Thanks DV, this was the info I was hoping to get.

 

[wingflyer152]

I have one question for you guys. What if somebody told you you couldn't dive? There are avenues that you people are failing to see that we epileptics have so that we can scuba dive. As a diagnosed epileptic, I was told that I would never fly my airplane or scuba dive again. However, I safely do both. I fly as a private pilot with a Certified Flight Instructor as a safety pilot in the right seat. I scuba dive with an AGA full face mask with an oral nasal cavity in case I have a seizure underwater, I will not lose the second stage and drown like you guys have said. You didnt even explore the possibility of this. You left it out alltogether. I also have underwater communications with my dive buddy, who is knowledgeable of my condition and what to do.
I am sick and tired of you losers trying to make diving sound more serious than it really is. It is not space flight, where you muset be in the best shape of anyone on earth. You people should really have much more of a sane and open mind about diving and things of this nature. Sure, there are concerns for safety, but most of the time, this can be resolved and the person still be able to scuba dive. After all, what right do you or DAN or PADI or anybody have to say that I can not scuba dive? You can say that until you are blue in the face, but until you are faced with a bad health situation that was not your fault and those in better health are denouncing you just to make themselves feel better or to make them selves sound more "elite" as divers, you will never understand our position. Also, nitrogen narcosis is a mild effect and a very mild risk when diving with a buddy in shallow water, all you must do is surface, or ascend for a time, after all people narc for fun!!! This is a prime example of you, DocVikingo trying to make the sport sound more "elite" as I stated before. Dont worry though, you are not alone, you have a lot of company in this sport. We disabled divers have a voice, and I will soon be hosting a URL to acnowledge the efforts of those who have overcome their disability, whatever it may be. Anyone who disagrees or agrees with me, feel free to email me at wingflyer152@aol.com with your concerns.

 

[ckharlan66]

Wingflyer152,

I love to dive but to answer you question if someone told me that I had a medical condition that made it infinately more dangerous to dive I would have to resign myself to never dive again.

Having an episode underwater would not only endanger yourself but also your buddy. If you go into convulsions you could also drown your buddy as he tried to save you.

You know these risk and choose to dive anyway. I hope you have taken the precaution of only diving with a qualified rescue diver and that you have informed your buddy of the risk.

Please don't take this as an attack but with the concern with which it was intended.

Chad

 

[jbd]

wingflyer152--having dealt with people experiencing an epileptic seizure on dry land I am curious as to what the the prodedures are in the event you have a seizure while underwater.

 

[wingflyer152]

since you cannot swallow your tongue, there is no precaution needed there. I have complex partial seizures where you just lose motor control and awareness. The chances of somebody going into a seizure and having the motor skills to hit their LP inflator hose, or anything of that nature is highly unlikely. Of course there are always risks that one must take, and I am not saying that I am not above these risks, nor can I say I do not take them, but all divers do take risks, that is a part of the sport. Of course us epileptics would be at a higher risk of something going wrong, from what I see, this is a somewhat trivial risk. And to answer Chad's questions, I am not meaning to be mean or to try to provoke a fight, but I do know the risks and I take them. If I have to pay the price to be like everybody else, to life my life to the fullest, then so be it. Is life really worth living if you cannot do what makes you happy? I made the choice, and I am the one to blame if something were to go wrong.

 

[jbd]

Wingflyer152--I was simply curious as to what needed to be done by your buddy that you mentioned knows what to do. I was not being judgemental about your diving or flying. If you're over 18 I could care less what risks you take in your life. It's your life--live it as you see fit. However, given the fact that you refer to the people in this thread as losers and the tone of the private message you sent to me I consider you to be a crock of cr*p.

 

[decapoddiver]

...I agree that if you want to do something that could possibly be risky for you , go right ahead. The day you ask me to partake in something that could be dangerous to me though, HELL NO! People do all sorts of dangerous stuff all the time but it doesn't bother me until I am somehow involved.
I assume that you only go diving with the same buddy and NEVER go as part of a group that would have no idea what to do in case of emergency. What if I was on the same boat as you and saw you have a seizure and didn't know about your condition? Assuming your buddy wasn't right next to you (which happens all the time).
You mentioned the type of seizures you have and I can understand how you could dive safely with the precautions you have taken. There is more than one type though and I've seen some that would be fatal underwater. By all means fight for your rights but please don't get upset when others show concern.

P.S. If you informed me prior to the dive about your condition, I would not have a problem diving with you, considering your type of symptoms. I'm not out to stop all people with seizures from enjoying our sport.