Sezuire Free for 15 years

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NHDiver

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Hello,

I have read a couple of posts on the board regarding diving and epilepsy and the overall opinion is to hang up the fins. I did have epilepsy when I was an kid but I have been sezuire free and off medication for 15 years. I think it's ok to dive what do you think?

Shawn
 
Given that history, a diver would be fit to dive by UK Sport Diving Medical Committee standards, which read:

"Neurological- epilepsy

An epileptic attack occurring underwater while using conventional scuba equipment is usually a fatal event, since the mouthpiece is likely to be lost and large quantities of water inhaled during the clonic phase of the fit. It is therefore imperative that no epileptic should dive if there is any serious possibility of an attack occurring underwater.

A second factor which has to be considered is the nature of the drugs used to control epilepsy, which are all, to some degree, sedative in nature and would thus exacerbate nitrogen narcosis or cause it to come on at an unexpectedly shallow depth. For this reason, it is not considered safe for any epileptic to dive if he/she is currently taking any anti-epileptic medication.

Since hyperbaric oxygen is known to provoke convulsions in normal individuals, it was formerly considered that epileptics would be at increased risk when exposed to the raised partial pressure of oxygen in compressed air breathed at depth. However, it is now known that the mechanism of the attack is different, and epileptics are not more susceptible to convulse under pressure. Thus, this factor can be disregarded.

The relapse rate in epileptics who are taken off medication decreases exponentially, with the majority of those relapsing doing so within the first eighteen months of ceasing treatment and the rate of relapse becoming insignificant after three years.

The suggested requirements for an epileptic to be permitted to dive are therefore set at five years free from fits and off medication. Where the fits were exclusively nocturnal, this can be reduced to three years.

A past history of petit mal should not disqualify, provided that no attacks have occurred for five years and that the condition has not progressed to epilepsy. Pyrexial convulsions in childhood may be disregarded if not followed by epilepsy."

Here in the US, when a diver checks the medical questionnaire as positive for epilepsy/seizures training agencies & dive ops want to see written clearance to dive from a physician.

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.

Best regards.

DocVikingo
 
Very interesting information you provided to Shawn!

Nevertheless i'd really like your opinion on my case which has obvious parallels.
I had one short attack in which I lost conciousness (18 months ago), MRI scan showed no damage, EEG showed a little electric activity that other people do not have, according to my physician its probably something i was born with but also lived with for 47 years (and did a lot of diving and other sports). Based on this I never was diagnosed with epilepsy.

At the time I was under huge (working-)stress and just 1 week from a well earned holliday. It's my opinion stress was the initiating factor in this. I changed my life quite a bit so i'm confident I can dive as before. I think changes on a relapse are minimal.

My questions:

Is stress a known initiator?

What is your personal opinion in this case?
(3 years / 5 years / being unrealistically carefull does that exist too?)

Do you know the name of an specialized fysician (either in the UK or US) whose opion would convince also insurance companies and diving orgs?

Thanks in advance

bert metzger
the netherlands

=======

DocVikingo:
Given that history, a diver would be fit to dive by UK Sport Diving Medical Committee standards, which read:

"Neurological- epilepsy

An epileptic attack occurring underwater while using conventional scuba equipment is usually a fatal event, since the mouthpiece is likely to be lost and large quantities of water inhaled during the clonic phase of the fit. It is therefore imperative that no epileptic should dive if there is any serious possibility of an attack occurring underwater.

A second factor which has to be considered is the nature of the drugs used to control epilepsy, which are all, to some degree, sedative in nature and would thus exacerbate nitrogen narcosis or cause it to come on at an unexpectedly shallow depth. For this reason, it is not considered safe for any epileptic to dive if he/she is currently taking any anti-epileptic medication.

Since hyperbaric oxygen is known to provoke convulsions in normal individuals, it was formerly considered that epileptics would be at increased risk when exposed to the raised partial pressure of oxygen in compressed air breathed at depth. However, it is now known that the mechanism of the attack is different, and epileptics are not more susceptible to convulse under pressure. Thus, this factor can be disregarded.

The relapse rate in epileptics who are taken off medication decreases exponentially, with the majority of those relapsing doing so within the first eighteen months of ceasing treatment and the rate of relapse becoming insignificant after three years.

The suggested requirements for an epileptic to be permitted to dive are therefore set at five years free from fits and off medication. Where the fits were exclusively nocturnal, this can be reduced to three years.

A past history of petit mal should not disqualify, provided that no attacks have occurred for five years and that the condition has not progressed to epilepsy. Pyrexial convulsions in childhood may be disregarded if not followed by epilepsy."

Here in the US, when a diver checks the medical questionnaire as positive for epilepsy/seizures training agencies & dive ops want to see written clearance to dive from a physician.

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.

Best regards.

DocVikingo
 
Bert Metzger:
Is stress a known initiator?
I would say so. There are lots of different triggers for seizures. I've had a few grand mal seizures in my life, twice after medical procedures. An EEG showed extra electrical activity, and my neurologist thought the physical stress of the medical procedures put me over the threshhold. With hindsight, perhaps it was the anesthetic, or some combination.

Sure, scuba diving doesn't involve surgery or anesthesia (I would hope not! :D ). Nonetheless, I would be hesitant to dive. After all, there are lots of possible triggers.

Perhaps you should explore the Internet for informational sites on epilepsy. If you enjoy online forums as a way to learn, try the Epilepsy Foundation's list of online communities. I hope this helps!
 

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