People with epilepsy should be encouraged to participate in sports and activities, but risks can be higher, and common sense is required. Epilepsy is a considerable risk factor for drowning. Bell and colleagues from the UK have analyzed published literature to determine the level of increased risk (Neurology 2008, volume 71, page 578). In England and Wales during 1999–2000, 88 drowning deaths were observed in people with epilepsy, compared to about 5 expected, giving almost a 19-fold increased risk of drowning. A bigger risk was found for bathtubs (96-fold increased risk in children) than for swimming. This suggests several safety points. People with epilepsy and their families should be aware of increased risk from bathing and swimming. Unless seizures are fully controlled, people should not take unsupervised baths. Instead, use a shower, with a plastic stool and a hose line, or find someone who can supervise a bath. Swimming should be with a buddy system for any swimmers, and this is even more important for people with epilepsy. See a video of other recreational risks.

Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief, epilepsy.com