Understanding epilepsy

Most swimming teachers and coaches will have a swimmer with epilepsy in their class or squad at some time, and in the vast majority of cases fits will be very well controlled with appropriate anti-convulsant medication.

There is no reason why people with epilepsy can’t enjoy swimming as a hobby or compete at the highest level in the sport provided simple precautions are taken.

If you are a coach with an epileptic athlete you need to:

• be aware of the condition
• knows what to do if a swimmer has a seizure in the water or poolside
• knows the factors which increase the likelihood of a fit happening in the pool.

It is sensible for the person with epilepsy to gain his or her doctor’s permission to swim to ensure that control of the fits is optimal during training. A person with epiepsy should also let the pool authorities and coach know about the epilepsy.

Types of epilepsy

There are many forms of epilepsy and they are classified into ‘partial’ (no loss of consciousness) and ‘generalized’ (loss of consciousness). Here are some common examples:

• Absences (petit mal) - a transient lapse in consciousness or awareness lasting a few seconds
• Generalised tonic clonic fits (grand mal) - loss of consciousness , fall (possible injury) , tonic (stiffening) phase , clonic (rhythmical jerking), recovery with drowsiness and confusion.
• Temporal lobe epilepsy - often starts with funny smells, sounds or tastes followed by convulsions
• Myoclonic epilepsy - brief muscle jerks

With all of the above there is the risk of drowning and no sufferer from the condition should ever swim alone. From a practical viewpoint this will mean training in an indoor pool with lifeguard facilities and resuscitation equipment.

A bright cap in a group can aid identification and it is useful to have a third party, such as a parent, on the balcony or poolside to keep an additional eye on the swimmer. Remember, any medication must be declared to doping control.

What to do if a swimmer has a fit in the water

In this situation there are a number of steps you can take. They are:

• Reach the swimmer as soon as possible approaching from behind if a generalised convulsion
• Aim to keep the head above water
• Once the convulsion is over remove the person from the water as soon as possible
• Place the person in the coma position on poolside to complete the recovery, keep him or her warm
• Resuscitate if breathing has stopped

The are a number of factors that can increase the likelihood of a fit occurring during swimming, so it is vital you are aware of these

• Overtiredness, over training and fatigue. Avoid these
• Stress
• Shimmering lights on the water surface, particularly from sunlight or fluorescent lights
• Cold water temperatures
• Infections or fever. Ensure epilepsy sufferers don’t swim if they have a viral illness
• Hypoglycaemia (low blood glucose). Use glucose replacement drinks during training