By: Nicholas Parekh
For many epileptic patients, exercise has been seen as a dangerous activity due to it potentially inducing seizures or increasing seizure frequency. Studies have shown that these fears have largely been overblown. One study showed that only 2% of epileptic patients had exercise-induced seizures. Another showed that 4 weeks of consistent aerobic exercise did not impact seizure frequency. EEGs tend to lose epilepsy-like brain wave patterns during exercise. Despite this, people with epilepsy exercise at a lower frequency than the general population, resulting in lower overall fitness and quality of life.
Epileptic patients are at a higher risk of developing obesity due to the greater lack of physical activity among this population. One study showed that children with epilepsy tend to have a higher body mass index (BMI) than their siblings. Some antiepileptic drugs such as pregabalin and vigabatrin are also known to promote weight gain. Consistent exercise may help mitigate this side effect of antiepileptic drugs, preventing the development of obesity and other chronic metabolic diseases such as Type II diabetes and heart disease.
Besides physical illnesses like obesity, epileptic patients suffer from mental illness at a higher frequency than the general population. Abnormal production and release of neurotransmitters like serotonin, dopamine, and norepinephrine in epileptic patients likely contribute to depression and anxiety in epileptic patients. Exercise increases the production of those same neurotransmitters and reduces overall stress levels, improving symptoms of depression and anxiety and contributing to a better quality of life. Moreover, stress is a common trigger of seizures in epileptic patients, so exercise can reduce the frequency of seizures by alleviating stress.
Besides addressing non-neurological areas of health, exercise can both prevent the development of epilepsy and mitigate the physiological damage caused by epilepsy. Researchers believe that habitual exercise early in life can create a “neural reserve” that can buffer against the development of neurological disorders like epilepsy. A study on rats showed that exercise delayed the first chemically-induced seizure and reduced subsequent seizure intensity. An exercise program was shown to decrease seizure frequency in women with severe epilepsy. Even when a patient already has a seizure disorder, exercise can help prevent seizure flare-ups and reduce neurological damage. Scientists have shown that exercise can upregulate a protein called parvalbumin which binds to excess intracellular calcium during a seizure and prevents the neuron from being killed.
Although epilepsy should still be managed through traditional means (i.e. antiepileptic drugs, surgery, etc.), exercise can be integrated into a treatment regimen to reduce seizure frequency, protect brain health, and prevent the development of chronic metabolic disease and mental illness. Before beginning any exercise program, epileptic patients should consult their doctor to see which activities are safe and do these activities under supervision.
Citations
Arida, Ricardo Mario et al. “Experimental and clinical findings from physical exercise as complementary therapy for epilepsy.” Epilepsy & behavior : E&B vol. 26,3 (2013): 273-8. doi:10.1016/j.yebeh.2012.07.025
Ben-Menachem, Elinor. “Weight issues for people with epilepsy–a review.” Epilepsia vol. 48 Suppl 9 (2007): 42-5. doi:10.1111/j.1528-1167.2007.01402.x
