From the Guidelines
A child with seizures can be cleared to play football if their seizures are well-controlled, typically seizure-free for 3-6 months, and with the specific recommendations of their neurologist. The decision to clear a child with seizures to play football depends on several factors, including the type of seizures, how well they're controlled, and the specific recommendations of their neurologist 1. Generally, children with well-controlled seizures may be cleared to play football, but medication adherence is crucial, with common anti-seizure medications including levetiracetam (Keppra), valproic acid (Depakote), lamotrigine (Lamictal), or oxcarbazepine (Trileptal) needing to be taken consistently as prescribed.
The neurologist will evaluate seizure frequency, triggers, medication effectiveness, and overall health before making a decision. Some children may be cleared with certain restrictions, such as avoiding overheating, maintaining regular sleep patterns, and ensuring proper hydration. Parents should ensure coaches and staff are aware of the condition and know seizure first aid. The risk assessment balances the physical and social benefits of sports participation against the potential risks of head trauma, which could potentially trigger seizures in some individuals. According to a study published in Pediatrics in 2015, the risk of catastrophic injuries to the head and neck in football is low, with yearly estimates between 0.19 and 1.78 for every 100,000 participants 1.
Key considerations for clearing a child with seizures to play football include:
- The type and frequency of seizures
- The effectiveness of medication in controlling seizures
- The child's overall health and well-being
- The potential risks of head trauma and the measures in place to minimize these risks
- The importance of proper hydration, sleep patterns, and avoiding overheating
- Ensuring that coaches and staff are aware of the child's condition and know seizure first aid. It's essential to weigh these factors carefully and make a decision based on the individual child's needs and circumstances, prioritizing their morbidity, mortality, and quality of life above all else.
From the Research
Clearance for Football Participation
- A kid with seizures can be cleared for football participation, but it depends on individual circumstances and medical evaluation 2, 3, 4.
- The risk of injury and seizure exacerbation due to participation in football for patients with epilepsy is low, but clinicians should use their best judgment in deciding whether contact sports increase risks for a particular patient based on individual seizure frequency, concurrent neurological and medical issues, and medication adverse effects 3.
- Exercise and physical activity can decrease seizure frequency and lead to improved cardiovascular and psychologic health, and most sports are safe for epileptics to participate in with special attention to adequate seizure control, close monitoring of medications, and preparation of family, coaches, or trainers 2, 4.
Factors to Consider
- The type and frequency of seizures, as well as the effectiveness of medication, should be taken into account when evaluating a child's eligibility to participate in football 3, 5.
- Children with epilepsy may have comorbidities such as intellectual disability, learning disability, and attention-deficit/hyperactivity disorder, which should be considered when making decisions about sports participation 5.
- The choice of antiepileptic medication and its potential side effects should also be considered, as some medications may be more suitable for athletes than others 6.
Medical Evaluation and Guidance
- A thorough medical evaluation and guidance from a healthcare professional are essential in determining whether a child with seizures can participate in football safely 2, 3, 4.
- Clinicians should assess the individual's seizure control, medication regimen, and overall health status to make an informed decision about sports participation 3, 4.