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Title: [abstract] SEIZURES IN DIVERS.
Author: Massey, EW; Dovenbarger, JA; Nord, DA; de L Dear, G; Moon, RE
Abstract: INTRODUCTION: A history of a seizure disorder has traditionally been considered a contraindication to diving. Three cases of underwater seizures in known epileptics, with one death, have been reported to DAN. Prohibition of activities such a driving a car are conventionally lifted after a seizure-free interval. The question has been raised as to whether the available data support resumption of scuba diving after such an interval. Of 29,239 calls to the DAN information line from 1997 to 1999, 212 calls were regarding seizures. Seven were regarding new-onset seizures after diving. METHODS: The literature was reviewed to evaluate the risk of a patient with a single seizure of developing a second seizure. RESULTS: After a single unprovoked seizure, with no risk factors and normal examination, MRI and EEG has a 25% chance of recurrence within 2 years. With abnormal (focal) examination or abnormal EEG at occurrence, the risk doubles. Anti-convulsant therapy may allow for modest delay in occurrence. A 5 year follow-up analysis (Neurology. 40: 1163, 1990) demonstrated individuals with no risk factors have a recurrence rate of 21% over 5 years. However, previous neurological insult (head injury, CNS infection, encephalopathy at birth), family history of epilepsy, abnormal EEG, status epilepticus, Todd's paresis or multiple seizures had a higher risk. The majority of recurrences are within 2 years. For individuals who have had a second seizure, the risk of a third unprovoked seizure is 73% (N Engl J Med 338:429, 1998). Recurrence of seizures more than 5 years after an initial event is several fold greater than new onset seizures in the general population. CONCLUSION: Current guidelines prohibiting scuba diving after a seizure are supportable by available evidence.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/6947
Date: 2000

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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