Epilepsy in football players and other land-based contact or collision sport athletes: when can they participate, and is there an increased risk?

We discuss the impact of epilepsy on the lives of athletes involved in contact sports. Recommendations for epilepsy patients with regard to contact sports have changed over the years from avoidance to encouragement. It is conceivable that exercise could exacerbate seizures either directly, through hyperventilation, or indirectly by alteration of anticonvulsant levels. Seizures could also be injurious in contact sports, and recurrent minor head trauma could worsen epilepsy. However, evidence to the contrary abounds and very few case reports support these notions. Exercise benefits individuals with epilepsy in many ways including improved seizure control, mood, and quality of life. We suggest that athletes with epilepsy be evaluated on an individual basis, and follow sensible guidelines while participating in contact sports. There is no significant evidence to suggest that contact sports are harmful to athletes with epilepsy; however, common sense rules still apply.