Abstracts

There is little evidence to suggest that contact sports such as football are detrimental to patients with epilepsy and there are established physical and psychosocial benefits of exercise. However, physicians frequently recommend restriction of these activities from this patient population with the thought that seizures can be exacerbated by frequent head trauma or these patients may be more prone to sustain contact-related injuries during seizures. We sought to evaluate the rate of reported football injury in epilepsy patients. We electronically queried 157,709 clinic notes between the years 1994-2004 in the University of Virginia Neurology Department clinical database by searching the text word [quot]football[quot]. Each note was read to determine whether the patient had epilepsy. If the patient had epilepsy and had ever participated in football according to the documentation, he was included in the results. The clinic notes were thoroughly reviewed for any mention of football related injury. It was assumed that if football related injury was not mentioned in the note, then none occurred. We found 95 clinic notes of seizure patients who were involved with football. This corresponded to 60 patients since several had [quot]football[quot] mentioned in more than one office visit. Participation in football was reported in 44 and 7 of these (15.9%) sustained an injury. Of the 16 who mentioned football, but did not play, 8 mentioned they were planning to try out for football and 6 patients had been advised against playing football by their neurologist. Epilepsy precipitated by frequent head injuries from football was thought to have occurred in 2 other patients. Of the 7 football players who reported injury, the clinic note in only one patient suggested that his underlying epilepsy (absence seizures) may have contributed to the injury. The other 6 players seemingly sustained injuries unrelated to their underlying neurological diagnosis. Our results suggest that the rate of football related injury in patients with known well controlled epilepsy is low and possibly no greater than the general population, which was reported at 39% in a 1995 National Athletic Trainers Association study. However, our data are dependent on the spontaneous reports of patients that physicians chose to include in the medical record so it is possible that injuries occurred but were not reported. It is also possible that few epilepsy patients play football so there are few opportunities for injury. Patients may avoid football either because they fear it will exacerbate seizures or their physician recommends against it, as we found in some cases. Clinicians should certainly use their best judgment in deciding if contact sports such as football should be allowed but the data support a decision to allow participation in football.