癫痫、痫性发作、体育锻炼和运动：ILAE 运动与癫痫工作组的报告_Journal of Epilepsy

Authors：

CapovillaG , KaufmanKR , PeruccaE , 吴梦倩　译 , 慕洁　审

Corresponding author：

Keywords：

癫痫; 痫性发作; 体育锻炼; 运动; 健康证明

DOI：

10.7507/2096-0247.20180016

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癫痫患者（People with epilepsy，PWEs）通常被建议不要参与体育运动和锻炼，主要是因为恐惧、过度保护，以及对与此类活动有关的具体利益和风险的无知。现有证据表明，体育锻炼和积极参与体育运动除了有广泛的身体及心理社会效益外，可能会有利于癫痫的控制。国际抗癫痫协会（ILAE）运动与癫痫工作组共同提出的这一共识提供了 PWEs 参与体育活动的一般性指导意见，并提出了不同运动的医疗健康证明的发放建议。如果发生痫性发作，运动会根据潜在的伤害或死亡风险分为三类：第一类，没有重大额外风险的运动；第二类，对 PWEs 有适度风险的运动，但不承担风险；第三类，具有重大风险的运动。在提供 PWEs 是否可以参与具体活动的建议时，应考虑的因素包括体育类型、癫痫发生概率、癫痫类型和严重程度、癫痫的促发因素、平常痫性发作的时间，以及患者接受一定程度风险的态度。由于获得了额外数据，运动与癫痫工作小组将此文件视为一项不断更新的工作。

Citation： CapovillaG, KaufmanKR, PeruccaE, 吴梦倩　译, 慕洁　审. 癫痫、痫性发作、体育锻炼和运动：ILAE 运动与癫痫工作组的报告. Journal of Epilepsy, 2018, 4(1): 66-71. doi: 10.7507/2096-0247.20180016 Copy

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2.	Kaufman KR, Kaufman ND. Stand up for epilepsy San Diego photo-shoot: a personal odyssey. Epileptic Disord, 2013, 15(3): 211-220.
3.	Pimentel J, Tojal R, Morgado J. Epilepsy and physical exercise. Seizure, 2015, 25(3): 87-94.
4.	Gotze W, Kubicki S, Munter M, et al. Effect of physical exercise on seizure threshold. Dis NervSyst, 1967, 28(7): 664-667.
5.	Esquivel E, Chaussain M, Plouin P, et al. Physical exercise and voluntary hyperventilation in childhood absence epilepsy. Electroencephalogr Clin Neurophysiol, 1991, 79(4): 127-132.
6.	Nakken KO, Løyning A, Løyning T, et al. Does physical exercise influence the occurrence of epileptiform EEG discharges in children?. Epilepsia, 1997, 38(4): 279-284.
7.	Camilo F, Scorza FA, de Albuquerque M, et al. Evaluation of intense physical effort in subjects with temporal lobe epilepsy. Arq Neuropsiquiatr, 2009, 67(4): 1007-1012.
8.	Vancini RL, de Lira CA, Scorza FA, et al. Cardiorespiratory and electroencephalographic responses to exhaustive acute physical exercise in people with temporal lobe epilepsy. Epilepsy Behav, 2010, 19(4): 504-508.
9.	de Lima C, Vancini RL, Arida RM, et al. Physiological and electroencephalographic responses to acute exhaustive physical exercise in people with juvenile myoclonic epilepsy. Epilepsy Behav, 2011, 22(3): 718-722.
10.	Arida RM, de Jesus Vieira A, Cavalheiro EA. Effect of physical exercise on kindling development. Epilepsy Res, 1998, 30(1): 127-132.
11.	Arida RM, Scorza FA, dos Santos NF, et al. Effect of physical exercise on seizure occurrence in a model of temporal lobe epilepsy in rats. Epilepsy Res, 1999, 37(6): 45-52.
12.	Arida RM, Sanabria ER, da Silva AC, et al. Physical training reverts hippocampal electrophysiological changes in rats submitted to the pilocarpine model of epilepsy. Physiol Behav, 2004, 83(5): 165-171.
13.	Arida RM, Scorza CA, Scorza FA, et al. Effects of different types of physical exercise on the staining of parvalbumin-positive neurons in the hippocampal formation of rats with epilepsy. Prog Neuropsy-chopharmacol Biol Psychiatry, 2007, 31(2): 814-822.
14.	Wong J, Wirrell E. Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy. Epilepsia, 2006, 47(1): 631-639.
15.	Hillman CH, Castelli DM, Buck SM. Aerobic fitness and neurocognitive function in healthy preadolescent children. Med Sci Sports Exerc, 2005, 37(2): 1967-1974.
16.	Hillman CH, Pontifex MB, Raine LB, et al. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Neuroscience, 2009, 159(3): 1044-1054.
17.	Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults.Med Sci Sports Exerc, 2009, 41(8): 1510-1530.
18.	Schmitt B, Thun-Hohenstein L, Vontobel H, et al. Seizures induced by physical exercise: report of two cases. Neuropediatrics, 1994, 25(2): 51-53.
19.	Ogunyemi AO, Gomez MR, Klass DW. Seizures induced by exercise. Neurology, 1988, 38(4): 633-634.
20.	Sturm JW, Fedi M, Berkovic SF, et al. Exercise-induced temporal lobe epilepsy. Neurology, 2002, 59(5): 1246-1248.
21.	Decree of the Italian Ministry of Health. Rules concerning the medical protection of athletic activity. Rome: Gazzetta Ufficialedella Repubblica Italiana,1982: 63.
22.	Brukner P, White S, Shawdon A, et al. Screening of athletes: Australian experience. Clin J Sport Med, 2004, 14(3): 169-177.
23.	Corrado D, Basso C, Schiavon M, et al. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. J Am Coll Cardiol, 2008, 52(7): 1981-1989.
24.	Corrado D, Schmeid C, Basso C, et al. Risk of sports: do we need a preparticipation screening for competitive and leisure athletes?. Eur Heart J, 2011, 32(4): 934-944.
25.	Steinvil A, Chundadze T, Zeltser D, et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death-proven fact or wishful thinking?. J Am Coll Cardiol, 2011, 57(3): 1291-1296.
26.	Desomer A, Gerkens S, Vinck I, et al. Cardiovascular Pre-participation Screening in Young Athletes. Health Technology Assessment (HTA) Brussels: Belgian Health Care Knowledge Centre (KCE). 2015, KCE Reports: 241.
27.	Dvorak J, Grimm K, Schmied C, et al. Feasibility of precompetition medical assessment at FIFA World Cups for female youth players. Br J Sports Med, 2012, 46(2): 1132-1133.
28.	Madsen NL, Drezner JA, Salerno JC. Sudden cardiac death screening in adolescent athletes: an evaluation of compliance with national guidelines. Br J Sports Med, 2013, 47(3): 172-177.
29.	US Rowing. ECG & Health Screening Requirement. Available at: http://www.usrowing.org/nationalteams/ecg_health_screening_requirement. Accessed May 30, 2015.
30.	Winston GP, Jaiser SR. Western driving regulations for unprovoked first seizures and epilepsy. Seizure, 2012, 21(5): 371-376.
31.	Commission Directive 2009/113/of 25 August 2009 amending Directive 2006/126/EC of the European Parliament and of the Council on driving licenses Official Journal of the European Union 26.8.2009; L 223: 31-35. Available at https://www.idf.org/ sites/default/files/idfeurope/European%20Directive%20-%20Driving%20Licence_2009.pdf. Accessed November 17, 2015.
32.	Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 2005, 46(3): 470-472.
33.	Fisher RS, Acevedo C, Arzimanoglou A, et al. A practical clinical definition of epilepsy. Epilepsia, 2014, 55(6): 475-482.
34.	Beghi E, Carpio A, Forsgren L, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia, 2010, 51(3): 671-675.

1. Howard GM, Radloff M, Sevier TL. Epilepsy and sports participation. Curr Sports Med Rep, 2004, 3(1): 15-19.
2. Kaufman KR, Kaufman ND. Stand up for epilepsy San Diego photo-shoot: a personal odyssey. Epileptic Disord, 2013, 15(3): 211-220.
3. Pimentel J, Tojal R, Morgado J. Epilepsy and physical exercise. Seizure, 2015, 25(3): 87-94.
4. Gotze W, Kubicki S, Munter M, et al. Effect of physical exercise on seizure threshold. Dis NervSyst, 1967, 28(7): 664-667.
5. Esquivel E, Chaussain M, Plouin P, et al. Physical exercise and voluntary hyperventilation in childhood absence epilepsy. Electroencephalogr Clin Neurophysiol, 1991, 79(4): 127-132.
6. Nakken KO, Løyning A, Løyning T, et al. Does physical exercise influence the occurrence of epileptiform EEG discharges in children?. Epilepsia, 1997, 38(4): 279-284.
7. Camilo F, Scorza FA, de Albuquerque M, et al. Evaluation of intense physical effort in subjects with temporal lobe epilepsy. Arq Neuropsiquiatr, 2009, 67(4): 1007-1012.
8. Vancini RL, de Lira CA, Scorza FA, et al. Cardiorespiratory and electroencephalographic responses to exhaustive acute physical exercise in people with temporal lobe epilepsy. Epilepsy Behav, 2010, 19(4): 504-508.
9. de Lima C, Vancini RL, Arida RM, et al. Physiological and electroencephalographic responses to acute exhaustive physical exercise in people with juvenile myoclonic epilepsy. Epilepsy Behav, 2011, 22(3): 718-722.
10. Arida RM, de Jesus Vieira A, Cavalheiro EA. Effect of physical exercise on kindling development. Epilepsy Res, 1998, 30(1): 127-132.
11. Arida RM, Scorza FA, dos Santos NF, et al. Effect of physical exercise on seizure occurrence in a model of temporal lobe epilepsy in rats. Epilepsy Res, 1999, 37(6): 45-52.
12. Arida RM, Sanabria ER, da Silva AC, et al. Physical training reverts hippocampal electrophysiological changes in rats submitted to the pilocarpine model of epilepsy. Physiol Behav, 2004, 83(5): 165-171.
13. Arida RM, Scorza CA, Scorza FA, et al. Effects of different types of physical exercise on the staining of parvalbumin-positive neurons in the hippocampal formation of rats with epilepsy. Prog Neuropsy-chopharmacol Biol Psychiatry, 2007, 31(2): 814-822.
14. Wong J, Wirrell E. Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy. Epilepsia, 2006, 47(1): 631-639.
15. Hillman CH, Castelli DM, Buck SM. Aerobic fitness and neurocognitive function in healthy preadolescent children. Med Sci Sports Exerc, 2005, 37(2): 1967-1974.
16. Hillman CH, Pontifex MB, Raine LB, et al. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Neuroscience, 2009, 159(3): 1044-1054.
17. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults.Med Sci Sports Exerc, 2009, 41(8): 1510-1530.
18. Schmitt B, Thun-Hohenstein L, Vontobel H, et al. Seizures induced by physical exercise: report of two cases. Neuropediatrics, 1994, 25(2): 51-53.
19. Ogunyemi AO, Gomez MR, Klass DW. Seizures induced by exercise. Neurology, 1988, 38(4): 633-634.
20. Sturm JW, Fedi M, Berkovic SF, et al. Exercise-induced temporal lobe epilepsy. Neurology, 2002, 59(5): 1246-1248.
21. Decree of the Italian Ministry of Health. Rules concerning the medical protection of athletic activity. Rome: Gazzetta Ufficialedella Repubblica Italiana,1982: 63.
22. Brukner P, White S, Shawdon A, et al. Screening of athletes: Australian experience. Clin J Sport Med, 2004, 14(3): 169-177.
23. Corrado D, Basso C, Schiavon M, et al. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. J Am Coll Cardiol, 2008, 52(7): 1981-1989.
24. Corrado D, Schmeid C, Basso C, et al. Risk of sports: do we need a preparticipation screening for competitive and leisure athletes?. Eur Heart J, 2011, 32(4): 934-944.
25. Steinvil A, Chundadze T, Zeltser D, et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death-proven fact or wishful thinking?. J Am Coll Cardiol, 2011, 57(3): 1291-1296.
26. Desomer A, Gerkens S, Vinck I, et al. Cardiovascular Pre-participation Screening in Young Athletes. Health Technology Assessment (HTA) Brussels: Belgian Health Care Knowledge Centre (KCE). 2015, KCE Reports: 241.
27. Dvorak J, Grimm K, Schmied C, et al. Feasibility of precompetition medical assessment at FIFA World Cups for female youth players. Br J Sports Med, 2012, 46(2): 1132-1133.
28. Madsen NL, Drezner JA, Salerno JC. Sudden cardiac death screening in adolescent athletes: an evaluation of compliance with national guidelines. Br J Sports Med, 2013, 47(3): 172-177.
29. US Rowing. ECG & Health Screening Requirement. Available at: http://www.usrowing.org/nationalteams/ecg_health_screening_requirement. Accessed May 30, 2015.
30. Winston GP, Jaiser SR. Western driving regulations for unprovoked first seizures and epilepsy. Seizure, 2012, 21(5): 371-376.
31. Commission Directive 2009/113/of 25 August 2009 amending Directive 2006/126/EC of the European Parliament and of the Council on driving licenses Official Journal of the European Union 26.8.2009; L 223: 31-35. Available at https://www.idf.org/ sites/default/files/idfeurope/European%20Directive%20-%20Driving%20Licence_2009.pdf. Accessed November 17, 2015.
32. Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 2005, 46(3): 470-472.
33. Fisher RS, Acevedo C, Arzimanoglou A, et al. A practical clinical definition of epilepsy. Epilepsia, 2014, 55(6): 475-482.
34. Beghi E, Carpio A, Forsgren L, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia, 2010, 51(3): 671-675.

Journal of Epilepsy

癫痫、痫性发作、体育锻炼和运动：ILAE 运动与癫痫工作组的报告

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