Does Physical Exercise Influence the Occurrence of Epileptiform EEG Discharges in Children?

Abstract

Summary:Purpose: To determine if, and how, epileptiform EEG discharges in children were influenced by physical exercise.Methods: Twenty-six children with intractable partial and generalized epilepsy exercised during video-telemetry recording, aiming at exhaustion after -10 min.Results: During the exercise, epileptiform discharges decreased in 20 of 26 children (17 children had at least 25% reduction) and showed a rebound increase after the exercise (17 of 26 children) compared to baseline conditions. This exerciseinduced reduction in epileptiform discharges reached statistical significance only in the 16 patients with localization-related epilepsy. Five patients showed an atypical EEG response to exercise with either unchanged or increased epileptiform activity while exercising. As compared to the other patients, these 5 children had experienced frequent clinical seizures during or immediately after exercise in their leisure time.Conclusions:In the majority of the tested children, epileptiform EEG discharges decreased during exercise. "Exercise-EEG" may be a helpful diagnostic tool to identify patients who are disposed to have exercise-induced seizures. Key Words: Epilepsy-Exercise-Interictal EEG discharge.Reduced physical fitness among people with epilepsy is most probably due to voluntary hypoactivity and lack of exercise (1,2). Many parents of children with epilepsy appear to have a persistent fear of exercise-induced seizures, a fear that often results in understimulation and overprotection of the children. In our experience, overprotected and sedentary children appear to continue to overprotect themselves as adults, and many people with epilepsy enter a vicious circle: hypoactivity-detrainingfunctional deterioration-further hypoactivity. This occurs despite the accepted advice from most of today's epileptologists: that is, people with epilepsy should be encouraged to lead as active and vigorous a life as possible (3).In a previous study, we reported that 4 weeks of intensive physical exercise among young, inactive patients with intractable epilepsy did not alter their seizure susceptibility significantly, although there were considerable individual variations (4). However, during the physical exercise, we made no EEG recordings of the patients. The aim of the present study was to evaluate whether intensive physical exercise influences the occur-

Evaluation of intense physical effort in subjects with temporal lobe epilepsy

“…In many patients, exercise may offer moderate protection against seizures 12 and eeG studies have shown that epileptiform activity is often reduced during physical exertion 13 . Only in a small part of patients, an increase in interictal discharges is seen during or after exercise 13 .…”

“…In many patients, exercise may offer moderate protection against seizures 12 and eeG studies have shown that epileptiform activity is often reduced during physical exertion 13 . Only in a small part of patients, an increase in interictal discharges is seen during or after exercise 13 . Another important point to be addressed is that although seizures do not occur frequently during low and moderate exercise, such as aerobic physical activities, some reports have also shown rare or no seizures during maximal physical effort 9,14 .…”

Participation in contact or collision sports in athletes with epilepsy, genetic risk factors, structural brain lesions, or history of craniotomy

“…30 Fear that increasing aerobic exercise may exacerbate seizures was magnified by several case reports of patients whose seizures were "triggered" by exercise. 53,55,57,68 Because hyperventilation has been shown to trigger absence seizures when performed at rest during a routine electroencephalography study, it was extrapolated that seizures could also be triggered during exercise-induced hyperventilation. Differences in the physiology of resting compared with exercise-induced hyperventilation make this unlikely.…”

“…28,54 In fact, interictal epileptiform activities remained unchanged or decreased during or immediately after exercise in the majority of patients studied, even in some patients with exercise-associated seizures. 29,34,55 Additionally, because of the general health and psychological benefits of aerobic exercise, it is recommended for most patients, although it must be recognized that this type of exercise will trigger seizures in some.An additional consideration in this population is the effect of exercise on drug metabolism. It is well known that exercise induces hepatic microsomal enzymes.…”

Ameliorating effect of hawthorn (<i>Crataegus oxyacantha</i>) and physical exercise on acute penicillin induced seizures in gerbils

“…According to some clinical studies, aerobic exercise training programs could either decrease (Eriksen et al, 1994) or have no effect on seizure frequency (McAuley et al, 2001). However, an exercise-induced increase in epileptiform EEG activity has also been reported (Horyd et al, 1981;Nakken et al, 1997). Treadmill running training is considered as the most frequently used aerobic exercise type in the experimental studies (Contarteze et al, 2009).…”