Is Scuba Diving Contraindicated in Someone Whose Epilepsy Is Under Control?

Gregory L. Krauss, MD

Disclosures

July 31, 2001

Question

Is scuba diving contraindicated in the controlled (3 years seizure-free) epileptic patient receiving carbamazepine 100 mg bid?

Fulton Velez, MD

Response from Gregory L. Krauss, MD

The 2 international scuba certification organizations, NAUI (National Association of Underwater Instructors) and PADI (Professional Association of Diving Instructors), and most physicians will not authorize patients with epilepsy to scuba dive.[1,2]

Drowning injury is a major risk for patients with seizures, and scuba diving is not an appropriate sport for patients with epilepsy. Scuba diving is done with a buddy, and thus someone with seizures jeopardizes the safety of their partner in addition to themselves. Furthermore, rapid ascent from medium to deep depths causes decompression sickness due to the formation of nitrogen bubbles.[3] A scuba diver recently died of cardiac complications from pulmonary barotrauma after rapid ascent during a seizure.[4] Despite these risks, I have 2 patients who obtained scuba certification prior to developing epilepsy, and they dive despite my warnings to them and their diving partners. I strongly discourage this, since I have had several patients drown or suffer neurologic complications during seizures while swimming. Safer sports can be elected.

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