Epilepsies and Diving

[Radioactive]

As an instructor I know that Epilepsy and diving is not recommended in any form. However, I have a customer who wants his wife to dive with him (safely of course), and would like to know to what extent or what level of epilepsy, (or maybe what type of epilepsy would be a better question) would diving become dangerous? I have already stressed to him that epilepsy in any form could be dangerous, but this (no matter how strongly I recommended against it) did not answer his question. He has informed me that IF she is seizure free for four months, she is allowed to have a driver license, and with her type of epilepsy, she knows before the on set of an attack. Yes I explained that even if she knows when the attack is coming, diving magnifies everything 10 fold, and if she is doing a deeper type diving there are other consideration on the accent (Bottom time in general, DECO stops, accent rate, etc.), besides just pulling the car over until the attack is complete. After a 45min conversation, I feel I have still not answer his question to his satisfaction. So I guess the question is as it stands...

 

[Drew Sailbum]

Disclaimer: Not from a physician

I am also an instructor and have a kid sister with epilepsy. I have a decent layman's understanding of the condition, but I'm sure a doctor can fill in more details.

Having a seizure underwater is not, in and of itself, particularly dangerous, but there is a very high risk of losing the regulator and drowning or suffering a pulmonary barotrauma due to rapid surfacing.

The more serious type of epileptic seizure is a tonic-clonic (formerly known as Grand Mal) seizure. This involves involuntary contraction of almost all major muscle groups.

During a tonic-clonic seizure it is likely that the regulator would be lost. Also, the person experiencing such a seizure with likely go through prolonged periods of breath holding. If the airway is closed as the person's buddy attempts to surface the individual, pulmonary barotrauma will likely result.

The less serious type of seizure is a petit mal seizure. In such a seizure, the person "blanks out" from a few seconds to a minute or two. Such seizure may be characterized by behaviors such as picking at one's clothing or lips. Again, loss of regulator with subsequent drowning is a concern.

With medication, many people achieve excellent control of their epilepsy. But many of the drugs used in the treatment of epilepsy are barbituates (depressants). Such drugs may tend to limit the extent to which the body can adapt to the increased physical demands of diving.

The industry standard is that any seizure disorder (other than childhood febrile seizures) is an absolute contraindication to sport diving. If your client may wish to discuss whether a physician would provide medical clearance with specified use of certain equipment such as a full-face mask. Have your client contact DAN for a referral to a physician (preferrably a neurologist) familiar with dive medicine.

Remember, determination of medical fitness to dive is the realm of a physician. Further, you are under no obligation to train someone just because a physician has provided medical clearance.

 

[DocVikingo]

Good Evening, Gentlemen,

You'd have better luck with this one in the dive medicine section than here in the decompression area. In fact, it was recently answered there at http://www.scubaboard.com/showthread.php?s=&threadid=4848&highlight=epilepsy

Have a stroll around the board. You may be surprised what's available.

Happy New Year.

DocVikingo