Ask a doctor on the topic of Neurology

Epilepsy, sports, and overheating

February 26, 2017 | 50,00 EUR | answered by Dr. med. Frauke Gehring

Hello, first of all, I know that online counseling cannot replace a visit to a neurologist. I am 25 years old and had my first generalized seizure at work (office) about 4 months ago. Initially, it was assumed to be an isolated incident, although slight EEG changes were already detected at that time (frontal slowing, a sharp wave). Then everything was quiet for a while. Four weeks ago, I had another generalized seizure while sleeping, and my roommate called the paramedics. I was put on Lamotrigine in the hospital, and so far, I have been tolerating it well. In 2 weeks, I will reach my final dose of 200mg, and then my levels will be checked. I suspect hormonal changes as the main trigger for my seizures (I had my period shortly after the first seizure, which is irregular for me, and I had just started taking birth control again before the second one). They say I should avoid stress. I have been doing intense sports for years, sometimes 4-5 times a week, and I am currently working on my doctoral thesis alongside my medical studies. Now my neurologist is being overly cautious (in my opinion). I was thoroughly examined at the epilepsy center, and a scar in the frontal lobe was found as the likely cause of my seizures, probably present since birth. Apart from the usual safety precautions and check-ups, I shouldn't worry too much. I am not exactly stress-free. I still practice martial arts (Wushu, non-contact, but with many jumps, etc.). We are planning a training trip to China for 2 weeks, 6 hours a day, at 40 degrees Celsius - with the option to rest if needed. I need to confirm my participation in 2 days. I really want to go. I can't get an appointment with my neurologist quickly. According to scientific articles, sports don't affect seizures, except for overheating and low blood sugar. What would you advise me to do?

Dr. med. Frauke Gehring

Good evening,

There is actually no evidence that exercise triggers seizures. Stress does, and you probably have plenty of that in your daily life. Therefore, it is not necessarily safer for you at home than on this trip.
However, travel stress should be kept to a minimum. You can take steps to prevent hypoglycemia and dehydration. Overheating is a risk, but since you also don't stay cool at home during your exercise, I don't see a major problem here either if you take appropriate breaks in the heat. Lack of sleep is dangerous, especially due to the time difference that could occur during travel. You should ensure you have sufficient rest, as sleep deprivation can trigger seizures.
In summary, there is a certain risk of seizures, despite being on Lamotrigine. Considering the stress of travel, it is slightly higher than at home, but I do not see it as an absolute contraindication.
I would clarify who can help you in case of a seizure. Is there easily accessible medical help? Do the accompanying persons feel prepared to assist you? If you can answer yes to both, I see no reason to forgo the trip.

I wish you all the best!