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“My daughter is a competitive swimmer. She feels that her anticonvulsant medication slows her down and tends to skip it on the days before her meets. I’m afraid that she will have a seizure. What should I tell her?”
You should tell her that the medication is far less likely than a seizure to interfere with her performance. You should make a contract with her that if she is mature enough to take training and swimming seriously, then she is also mature enough to manage her seizures and to take her medication reliably. If she feels that the medications are slowing her down, she should discuss this with her doctor. Perhaps he can lower the dose. But your daughter should not do this on her own. Perhaps the medication could even be discontinued if she has been seizure-free for a sufficient period of time.
“We’ve just moved to a new town, and Todd hasn’t had a seizure in almost a year. Should he tell his coach that he has epilepsy?”
Yes. That is the only way the coach can provide adequate supervision and be prepared if another seizure occurs. If the coach acts in a paternalistic way, then you may have a battle to fight. It is important that you and your child be honest with the coach, just as you expect him to be honest with you.
“Would you let an adolescent with epilepsy participate in a marathon or in one of those triathalons? Does the stress of these increase the chance of seizures?”
In general, stress of this sort does not increase the chance of a seizure. The training for the event might provide a very good test. We would allow him to try. If the training seemed to increase the frequency of seizures, he should probably not compete. If he’s had seizures before, he might be distressed if he had another one, but it would probably be less distressing than if he hasn’t even been allowed to try.

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