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Here is a piece I wrote for "Rodale's Scuba Diving" magazine sometime back:
"While medical nemeses such as diabetes and asthma have recently become subject to clearance to dive under conditions of proper control, seizure disorder has not fared as well. PADI, DAN and other major agencies continue to view adult epilepsy, controlled or not, as precluding diving. Certain types of early childhood convulsions can be medically excused, but it is mandatory that a diver with such a history have a completely normal neurological examination.
Understandably, this rankles the well-controlled individual who desires to dive. There are a number of very effective anticonvulsants available, and with diligent use about 80% of those affected can be well-controlled, and many entirely seizure-free. And although state laws vary, some allow medical clearance for driving a motor vehicle after being seizure-free for just 3 months. Medically controlled individuals legitimately ask, "Why can't I dive?"
In short, it's because a convulsion underwater can have dire consequences, and can occur even in those well-controlled on medication. With unconsciousness, loss of the second stage is almost certain, and water inhaled during an episode would likely result in drowning. Furthermore, the breath holding which can be occasioned by the tonic phases of a motor seizure increase the risk of pulmonary barotrauma during rescue attempts to bring the stricken diver to the surface. Finally, most seizure medication, to a greater or lesser extent, have sedative side effects and could impair mental sharpness and exacerbate nitrogen narcosis or cause it's appearance at shallower than expected depths.
The outlook for clearance to dive is somewhat rosier if you go for British Sub-Aqua Club certification. For those with a history seizure disorder who are not currently on medication, BSAC suggested requirements for medical clearance to dive include five years free from a convulsion off medication, reduced to 3 years when the events were exclusively nocturnal.
Clearly it is unwise to deny or minimize this condition to yourself, or hide it from your instructor or the ops with which you dive. If you have a seizure disorder and want to dive, or are already diving without medical clearance, it is critical that you consult a physician to obtain an appropriate medical work up & permission to dive."
As regards links, here's one by our man smiling Ernie Campbell:
Looking at diving or driving from a broader public point of view I think I would prefer a well controlled epileptic be diving instead of driving. With a seizure event in diving, more than likely one person dies and it would be the person who understood the risk. With a sezure event while driving several people can be killed or injured never knowing that they were at increased risk. Just personal observation on my part.
Thanks a lot DocV - that was just what I was looking for. I recently met a guy who would dearly love to dive but knows he can't because he still occasionally has seizures. I felt really bad for him but now I really understand why it's not possible for him. Such a shame.
jbd - it's true that less people might be affected by an epileptic diver as opposed to driver, however there would still be great risk to the buddy and anyone else who tried to help... It's obvious that epileptics should stay on the surface coz you just never know when it's going to hit.
Alison,
I agree that there is much more risk with any diver that has known health problems. I only recently became aware of the fact that some of the previous contra-indications to diving were being reconsidered. I had recently met someone local that was going to learn to dive which meant a dive buddy close by to dive with instead of frequent solo diving. Turns out the person had a history of seizures during childhood and adolescence. No seizures in over 10 years. The dive agency represented locally wouldn't allow this person to take the course. I know the person drives and may drive as part of their employment. This thread just made me think of the risks that we as a society allow or dis-allow a person to take and whether or not it makes sense.
I feel the same as you about the person not being able to dive--its kind of sad for them since we know how wonderful the underwater world is; but understandable that its for their own safety and well being that they not dive.
Following on from what you just said... 10 years is a long period of time to go "seizure-less". I wonder, Docs, is it ever possible, has it been documented that epilepsy just 'goes away'? Or does it stay with you forever?
Yes, seizures occasionally do "go away." Some individuals will have a single convulsive episode, either from a known or unknown cause, and never have another. Some will have a series of seizures, be placed on an anticonvulsant drug(s), and not have another even after medication is discontinued. Of course, yet others remain on medication with no further convulsive events. Sadly, a number of persons with epilepsy are never fully controlled.
The issue here is the unpredictability of future seizures & their potentially lethal consequences for the scuba diver.
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Thanks for a very interesting reply DocVikingo
