Jamal Musiala's Epilepsy Diagnosis: What You Need to Know
When Jamal Musiala suddenly crumpled to the turf in Bayern’s friendly against RB Leipzig on Saturday, the images shot around the world in seconds. For millions, it was a shock. For neurologist Dr Regina Becker, it was something else: a clear first suspicion.
“Because it happened so suddenly and he then obviously recovered quickly, as a neurologist I immediately thought of an epileptic seizure,” says Becker, who previously worked at the neurology clinic of the University Hospital of Munich’s Ludwig Maximilian University and now runs the “Munich Schwabing Neuro Centre”.
Musiala collapsed again three days later, this time against 1. FC Heidenheim. That second incident turned suspicion into diagnosis. In a public statement, the 23-year-old spoke of “temporary brief absences caused by a neurological dysfunction”. Behind that sober wording lies a very specific condition.
What is happening in Musiala’s brain?
Becker explains that Musiala is dealing with absence epilepsy, a form of epilepsy that originates in the thalamus – the part of the diencephalon that controls consciousness.
“Anyone who has a dysfunction there can suddenly become unresponsive,” she says. “The brain enters an exceptional state, the neurons start firing uncontrollably, and communication between the thalamus and the cerebral cortex, where we consciously perceive things, is interrupted.”
The result is brutal in its simplicity. The patient suddenly stops taking in their surroundings, stares into space – or, as in Musiala’s case, loses posture and falls. To those watching, it can look as if time has frozen around the player.
Most sufferers, Becker stresses, have no warning.
“It suddenly comes over them and they have no chance to react. Sometimes they do not even notice the seizure itself. Afterwards, they simply carry on as if nothing had happened.”
That is precisely what makes the condition so treacherous on a football pitch. Asked whether Musiala could, in theory, start his run-up for a penalty and then simply collapse mid-stride, Becker is blunt: “Yes, that is conceivable.”
Why he had to come off – and why he can still play
Both times Musiala went down in recent days, he was substituted immediately. From a purely physical standpoint, Becker explains, the 23-year-old is not dealing with a heart or organ problem.
“In itself, the patient has no problem with the cardiovascular system, the organs function normally,” she says.
But at elite level, that is not enough to justify leaving him on.
“In professional sport, carrying on is not possible for reasons of liability and duty of care. Factors such as heat and hyperventilation in particular could trigger further seizures, even if he himself is quickly fit again after a seizure.”
So the quick change is not a sign of long-term doom. It is a legal and medical necessity in the moment.
On the bigger question – his career – Becker is clear.
“With this form of epilepsy I have no concerns about his future career,” she says. The key will be the coming weeks, when his medication is adjusted. “In the adjustment phase of the medication, which is now presumably beginning, he will have to ease off a little so that the body has a chance to adapt.”
Why now – and what triggered it?
Musiala is 23. Absence epilepsy is usually associated with children. That contrast raises an obvious question: why is this only coming to light now?
“Normally, this form of epilepsy occurs between the ages of four and 10,” Becker explains. “However, there are also forms such as juvenile absence epilepsy, where the illness only appears later. In any case, 23 is late for a diagnosis.”
The truth, she adds, is that nobody outside Musiala’s inner circle can say for sure whether this has happened before in less visible settings.
“We do not know whether this had also happened to him earlier and has now simply become more frequent and happened in public for the first time.”
So what can cause that increase in frequency?
“Provided there is a genetic predisposition, environmental factors such as high temperatures, dehydration or stress can contribute to the frequency of seizures increasing, or even to the first seizure occurring at all.”
One thing she rules out immediately is any link to Musiala’s serious leg injury about a year ago.
No, that has nothing to do with it,” Becker says when asked about the broken fibula.
The treatment: daily pills, strong protection
In his own statement, Musiala described his condition as “treatable”. Becker backs that up without hesitation.
“Yes, there are very promising medications for absence epilepsy. Most patients become completely seizure-free as a result.”
The principle is straightforward, the execution meticulous. Patients receive seizure-suppressing medications that prevent the uncontrolled firing of neurons and are designed to block epileptic episodes before they start.
“They take the medication daily as a preventive measure, and it builds up the necessary level in the blood within two to three weeks,” Becker explains. During that period, doctors monitor the blood levels closely and adjust the dose if needed. “Once that level has been reached, there is normally sufficient protection against further seizures.”
The standard first choice is ethosuximide.
“In principle, it is a very well-tolerated medication, but it can lead to headaches and tiredness,” Becker says.
Another option is valproic acid, which is also highly effective but comes with a heavier side-effect profile: weight gain, hair loss, drowsiness.
“It has to be tried individually to see which medication is the best fit. Most patients tolerate both medications well.”
How long will Musiala have to take them? There is no one-size-fits-all answer.
“Even if the medications make someone seizure-free after a short time, they are taken for several months or years,” Becker says. In children, there is a realistic chance that the epilepsy disappears in adulthood and the medication can be stopped. “If the illness occurs later, lifelong therapy may be necessary. So the question cannot be answered in general terms, it varies from person to person.”
A career on pause, not on trial
For now, the picture is paradoxical: a neurological diagnosis serious enough to drop a player to the turf without warning, yet manageable enough that a full professional career remains on the table.
The next steps are clear. Medication. Careful adjustment. A short period of easing off the accelerator while his body adapts.
The stakes, though, are obvious. Bayern and Germany will want their playmaker back, but only once science, not sentiment, gives the green light.
