Yoga and Epilepsy: Very Impressive Study Results!

by Ram

A Pathway by Melina Meza

Epilepsy is a chronic disorder characterized by recurrent and unprovoked seizures. It is the fourth most common neurological disorder and affects people of all ages. Many people with epilepsy have more than one type of seizure and may also suffer from other health problems. An epileptic seizure occurs due to a faulty electrical event in the brain. The location of that electrical event, how fast it spreads in the brain and beyond, how much of the brain is affected, and how long it lasts, all have profound impact on the individual. Epilepsy is a spectrum disorder as it manifests into a wide range of seizure types. The differential diagnosis of patients presenting with epileptic seizure could range from a genetic disorder to a brain injury caused by a trauma or stroke or to a completely unknown reason. For every six of ten people with epilepsy, the cause is unknown. Due to lack of proper treatment, about one out of three people with epilepsy live with uncontrolled seizures. 

People are usually diagnosed with epilepsy if:

1. They have had at least one episode of seizure
2. They are likely to have more seizures
3. The seizure did not result from another condition like an infection 

An epileptic seizure arises primarily due to dysregulated electrical activity in the brain. This causes different symptoms ,depending on the type of seizure and the part of the brain that is involved. Seizures can take on many different forms and affect different people in different ways. They can be stereotypic (each episode happens the same way and is similar each time), episodic (they come and go) and unpredictable. But seizures do have beginning, middle, and end states.

Some people recognize the occurrence of a seizure hours or even days before it happens. Other people are unaware of any warning signs. Some of the warning signs that a seizure may come include:

1. Experiencing an “aura,” as the first symptom of a seizure. An aura is often a change in feeling, sensation, thought, or behavior. If seizures are episodic, the individual will experience a similar aura each time. During this part of the seizure, the individual is still conscious and aware of what is going on. 
2. Experiencing strange, negative, or scary feelings
3. Racing thoughts
4. Body parts feel or look different
5. Out of body feeling/experience
6. Feeling hot, cold, or sweaty and looking pale 
7. Heart racing or feeling dizzy or lightheaded
8. Nausea, headache, or unexplained pain in the body
9. Numbness, tingling, or feeling an “electric shock” in part of your body
10. Unusual smells, sounds, or tastes, or blurry vision

Another type of epilepsy called focal dyscognitive seizures or complex partial seizures involve a change or loss of awareness. The victim may stare into space, does not respond normally to the surrounding environment and may perform repetitive movements, such as hand rubbing, chewing, swallowing, or walking in circles. Having a seizure at certain times and not being aware of the symptoms can lead to circumstances that are dangerous to the individual and others. Reports of falling and sustaining severe injuries, drowning, car accidents, pregnancy complications, permanent brain damage, and death are some of the complications associated with epileptic seizures. People with epilepsy are also likely to have psychological problems, especially depression, anxiety, and, in extreme cases, suicidal tendencies. Problems may be a result of difficulties dealing with the condition itself as well as side effects from medications.People with low vagal tone are more sensitive to stress and can easily fall prey to epilepsy. “Vagal tone” defines the functional status of the vagus nerve, which is the 10th and largest cranial nerve. It relays information between the brain and other internal organs. It starts at the base of the skull and innervates the neck, chest, and abdomen, and provides information about the state of the body's organs to the central nervous system. Thus, the vagus nerve is responsible for a myriad of tasks including heart rate, breathing, respiration and digestion, peristalsis of gut, small intestine and colon, sweating, muscle movements in the mouth, speech, and hearing. Optimal physiological functioning is a direct reflection of the functional status of the vagus nerve. A sub-population of epileptic patients receive an implant called a vagus nerve stimulator underneath the skin of their chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in the neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to the brain that result in inhibiting seizures by 20 to 40 percent.Of course, it would be ideal to find treatments that could control epilepsy and reduce the need for anti-seizure medications. So researchers have been exploring the effect of yoga asanas in treating epilepsy, with the rationale that yoga is relaxing, reduces stress, and may reduce the excessive brain wave activity. In one such study, 20 patients (14 males, 6 females, age range 15 to 47 years) with established diagnoses of epilepsy underwent a yoga-meditation protocol (YMP) for 20 minutes twice daily (mornings and evenings) at home, and one supervised session of YMP every week for three months. Patients who remained in the program past three months continued the yoga-meditation protocol without any supervision. The outcome measure was the seizure frequency at three, six, and twelve months of the treatment period. At three months, a significant reduction in seizure frequency was noted in all except one patient. Of the sixteen patients who continued the yoga-meditation protocol beyond three months, fourteen patients showed a significant reduction in seizure frequency, with six of the patients being completely seizure-free. In another similar study, researchers examined the effects of posture, breathing, and meditation on autonomic functions of epileptic patients. The yoga group (n=18) received supervised training in yoga while a second group (n=16) practiced simple routine exercises. After ten weeks of daily functions, a subset of autonomic functions were measured. Data were compared with those of healthy volunteers (n=142). The yoga group showed significant improvement in parasympathetic parameters and a decrease in seizure frequency scores. While there was not much improvement in blood pressure parameters in either group, few patients in the yoga group achieved normal autonomic functions at the end of ten weeks of therapy, with limited changes in the exercise group.Both studies suggest that a yoga-meditation protocol may have a role as an adjunct therapy in the management of epilepsy, especially in patients with drug-resistant epileptic seizures. It is not surprising to see the beneficial effects of yoga-meditation protocol. Yoga’s benefits include but are not limited to increases in muscle strength and tone, improvement in respiration, energy and vitality, improvement in physical performance and increases in blood flow. Similarly, meditation reduces stress, anxiety, and depression, strengthens the brain areas, improves awareness, and strengthens the immune and cardiovascular function. 

Overall these study results are very impressive and very encouraging for those with epilepsy!

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