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23 September 2015

Reviewing rugby rules could minimise epilepsy risk

Little more than a week after Wales flanker Jonathan Thomas was forced to retire from professional rugby due to his epilepsy, a BBC Panorama documentary has revealed that changes to the rules of the game may be introduced to cut down the risk of players suffering concussion.

World Rugby’s chief medical officer Martin Raftery told Panorama that that a safety review was in progress that may lead to a revision of the laws governing the tackle, the element of the game where a player is most at risk from this type of injury.

Rugby players

He said the tackle was the area most likely to be the focus of any rulebook changes. World Rugby would be reviewing as many as 900 videos of concussions.

Epilepsy Society’s medical director welcomed the review which will identify risks and introduce changes that could give better protection to the players. He emphasised that debate around the risk of traumatic brain injury was important and stressed the seriousness of any injury to the brain.

'Rugby is a very physical contact sport and the rugby field can be a very unforgiving environment,’ said Professor Sander.

'Of course not all head injuries will result in brain injury or epilepsy but minor head injuries can be accumulative and may result in the onset of seizures. An assault to the brain may result in a scar or lesion which can cause bursts of unusual electrical activity in that area. Seizures may occur within the first week following an injury or they may not occur until many years later.'

Professor Sander stressed that personal response to injury was very individual. 'Ten people could experience exactly the same insult to the brain, yet maybe only a few of them would develop epilepsy,' he said. 'We do not know for sure why this is but we suspect there may be an underlying genetic contribution that means some people have a lower seizure threshold. The blow to the head may then become the trigger rather than the cause of the seizures.'

Statistics produced by the Rugby Football Union show that head injuries in professional rugby occur at a rate of about 3.9 per 1,000 player hours (one injury in every six games), in comparison with 1.2 injuries per 1000 player hours (one in every 21 games).Concussion rates in football are quoted at 0.4 per 1000 player hours.

Professor Sander continued: 'In a contact sport such as rugby, protecting the skull and the brain-blood barrier is of paramount importance and protective headgear, especially for players in the scrum, is imperative. It is vital to minimise risk.'

However, Professor Sander stressed that epilepsy itself should not be a barrier to playing contact sports such as rugby, but should be a consideration. 'People with epilepsy can easily become stigmatised with people fearing that they will have a seizure or that their epilepsy may compromise the overall performance of the team.'

'This is where honesty is important. Each individual should consult their medical team so that they can carry out a proper risk assessment and decide whether it is wise for them to continue with such sports.'

'There are many sportsmen and women who have epilepsy yet are able to continue with their career, but it is vital to make the appropriate individual risk assessments.'

Panorama's Rugby And The Brain: Tackling The Truth was broadcast on Monday night.

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Wales rugby star Jonathan Thomas quits rugby due to epilepsy