Abstract • The risks of submersion accidents, both drowning and near-drowning, for children with seizure disorders were calculated from the present study of six children with epilepsy in a total group of 100 children with postsubmersion syndrome and from five other reported studies. Analysis of data shows that the risk for patients with seizure disorders is four times that of the normal population. Persons with epilepsy should never swim without a lifeguard or competent swimmer being aware of the diagnosis and keeping close surveillance while they are swimming. Hyperventilation, a normal occurrence while swimming, may predispose patients with epilepsy to seizures and submersion accidents by increasing the propensity to seizures. In this study, three of the victims had at least one anticonvulsant drug level within the therapeutic range immediately after the submersion accident. Therapeutic drug levels are no guarantee that seizures will not occur during swimming. (Am J Dis Child 1982;136:777-780) References 1. Orlowski JP: Prognostic factors in drowning and the post-submersion syndrome . Crit Care Med 1978;6:94.Crossref 2. Orlowski JP: Prognostic factors in pediatric cases of drowning and near-drowning . Ann Emerg Med 1979;8:176-179. 3. Pearn J, Bart R, Yamaoka R: Drowning risks to epileptic children: A study from Hawaii . Br Med J 1978;2:1284-1285.Crossref 4. Adams AI: The descriptive epidemiology of drowning accidents . Med J Aust 1966;2:1257-1261. 5. Chun B, Okihiro MM, Hale RW: An analysis of drowning incidents in Oahu, 1960-1970 . Hawaii Med J 1973;32:92-95. 6. Dietz PE, Baker SP: Drowning: Epidemiology and prevention . Am J Public Health 1974;64:303-312.Crossref 7. Pearn JH. Epilepsy and drowning in childhood . Br Med J 1977;1:1510-1511.Crossref 8. Rose SW, Perry JK, Markush RE, et al: Prevalence of epilepsy in children . Epilepsia 1973;14:133-152.Crossref 9. Plan for Nationwide Action on Epilepsy . US Dept of Health, Education, and Welfare, No. (NIH) 78-276, vol 1, p 19. 10. Kirby RR: Near-drowning . Weekly Anesth Update 1978;1:1-6. 11. Golden FSC, Rivers JF: The immersion accident . Anaesthesia 1975;30:364-373.Crossref 12. Giammona ST: Drowning: Pathophysiology and management . Curr Probl Pediatr 1971;1:1-33.Crossref 13. Webster DP: Pool drownings and their prevention . Public Health Rep 1967;82:587-600.Crossref 14. Bowerman DL, Levisky JA, Urich RW, et al: Premature deaths in persons with seizure disorders: Subtherapeutic levels of anticonvulsant drugs in postmortem blood specimens . J Forensic Sci 1978;23:522-526. 15. Livingston S, Pauli LL, Pruce I: Epilepsy and drowning in childhood . Br Med J 1977;3:515-516.Crossref 16. Smith TC: Pharmacology of respiratory depression . Int Anesthesiol Clin 1971;9:125-143.Crossref 17. Borison HL: Central nervous respiratory depressants: Anesthetics, hypnotics, sedatives, and other respiratory depressants . Pharmacol Ther 1978;3:377-395. 18. Dalby MA: Epilepsy and three per second spike and wave rhythms: A clinical, electroencephalographic, and prognostic analysis of 346 patients . Acta Neurol Scand 1969;45( (suppl 40) ):3-183. 19. Miley CE, Forster FM: Activation of partial complex seizures by hyperventilation . Arch Neurol 1977;34:371-373.Crossref 20. Holmer I, Stein EM, Saltin B, et al: Hemodynamic and respiratory responses compared in swimming and running . J Appl Physiol 1974;37:49-54. 21. Wasserman K: Breathing during exercise . N Engl J Med 1978;298;780-785.Crossref 22. Mellor DH: Precipitating factors in epilepsy . Dev Med Child Neurol 1970;12:800-802.Crossref 23. Williams CE: Accidents in mentally retarded children . Dev Med Child Neurol 1973;15:660-662.Crossref 24. Berggreen SM: Accidents and surgical emergencies in a population of mentally retarded children . Acta Paediatr Scand 1972;62:289-296.Crossref 25. Pearn J, Nixon J: Bathtub immersion accidents involving children . Med J Aust 1977;1:211-213. 26. Treatment and prevention of drowning . Bull Int Civil Defense Organization 1980;301: 4-7.
American Journal of Diseases of Children – American Medical Association
Published: Sep 1, 1982
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