Neurological disease

People with neurological illnesses which affect the spinal cord or peripheral nerves must be carefully assessed with regard to their fitness for sport diving. The committee has no case reports of people with pre-existing spinal cord disease which would suggest an increase in susceptibility to spinal decompression but the numbers at risk must be very small. It is accepted that the functional recovery from spinal decompression sickness in sport divers is usually gained by utilising the reserve capacity of the spinal cord. There is an inevitable delay before recompression treatment and tissue damage occurs as a result of hypoxia and the secondary effects of bubbles. Individuals with pre-existing demyelination, tumours, syringomyelia, polio, or surgery, may therefore have a reduced reserve capacity already and it may be impossible to gain a functional recovery back to previous levels if there is an episode of spinal decompression sickness.

There would also be problems in assessing the neurological signs during any treatment for spinal decompression sickness which would make the management of recompression treatment difficult for the hyperbaric physician concerned. Spinal decompression sickness has occurred in sport divers despite using recognised decompression tables and safe diving practice. Cases of this nature should therefore be assessed on an individual basis by the medical committee and the risks of diving activity clearly explained to each individual.